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Biomedical subjects

Ron Eliashar

Publications and source records attributed to Ron Eliashar.

At least 55 records · Page 3Linked to original sources
PubMed2003

Adverse reaction to surgical sutures in thyroid surgery.

BACKGROUND: A mild reaction to surgical sutures after thyroid surgery is common and is characterized by local edema and inflammation around the surgical scar. Severe reaction with microabscesses and granulomatous masses is quite rare. METHODS AND RESULTS: Two cases of severe reaction to silk sutures after thyroid surgery are presented. Meticulous surgical removal of all surgical sutures along with granulomatous masses, granulation tissue, and microabscesses cured both patients. Pathologic examination revealed giant cells and lymphocytes. Intradermal skin tests were positive to silk sutures. The etiology and the treatment options are discussed. CONCLUSIONS: In rare cases, severe reaction to silk sutures may develop after thyroid surgery. Surgical removal of the stitches is the treatment of choice. Intradermal skin test is a good predictor of allergy to sutures.

Adult↗
PubMed2003

Pneumolabyrinth: an unusual finding in a temporal bone fracture.

Pneumolabyrinth or pneumocochlea are rarely found in temporal bone fractures. The presence of air in the inner ear is evidence of a pathological connection between the inner ear and the air-filled mastoid or middle ear cavities. A case of a pneumolabyrinth in a 2-years-old child is presented here. Diagnosis was made by means of a high resolution, thin sections computed tomography (CT) scan of the temporal bones, which is the imaging modality of choice in cases of otologic complaints after head trauma.

Air↗
PubMed2003

Characteristics of the type B tympanogram can predict the magnitude of the air-bone gap in otitis media with effusion.

Tympanometry is well established as a means of assessing the presence of fluid in the middle ear. The type B tympanogram is usually considered a unique entity. However, its shape may vary from a rounded type B with a "pseudopeak" to a completely flat response. The aim of this study was to compare the characteristics of the B curve (maximum admittance, tympanometric peak pressure, and area under the curve) to the viscosity of the middle ear fluid and to the air-bone gap (ABG). In 67 children (93 ears) who underwent ventilation tube insertion, no correlation was found between the viscosity of the middle ear fluid and the characteristics of the B curve. However, these characteristics were able to differentiate between a low ABG (0 to 20 dB) and a high ABG (>20 dB). A statistical difference was also found for the three parameters (maximum admittance, p < .0025; pressure, p < .025; and area under the curve, p < .0005). Tympanometry may be used as an objective measure to estimate the extent of conductive hearing loss, especially in young children.

Acoustic Impedance Tests↗
PubMed2002

A multidisciplinary team approach for management of a giant congenital cervical teratoma.

Congenital cervical teratomas are associated with a high rate of perinatal mortality due to airway obstruction. We describe a multidisciplinary management of a neonate with prenatal diagnosis of giant cervical teratoma. An 'operation on placenta support' (OOPS) technique was carried out during delivery, and intubation was successfully performed with no perinatal anoxic damage. Postnatal computed tomography and angiography showed a huge teratoma covering both sides of the neck with agenesis of the big blood vessels on the left side. A rapidly developing third space phenomenon and deterioration in the general status of the neonate, required early surgical intervention. During surgical excision, the left carotid artery and internal jugular vein, the left lobe of the thyroid gland and the left recurrent laryngeal nerve were not detected. The left vagus, accessory and hypoglossal nerves were positioned between the skin and the tumor, at a distance from their normal anatomical location. Pathologic examination confirmed the diagnosis indicating immature teratoma with no signs of malignancy. The postoperative period was complicated by neurological deterioration, pharyngo-cutaneous fistula and paresis of the left hypoglossal nerve. However, all the symptoms resolved spontaneously. Tracheotomy was performed when the baby was 6 weeks old due to paralysis of the left vocal cord and to severe laryngo-tracheomalacia. She was decannulated when she was 3 years old. Today, she is suffering only from dysphonia. This report confirms the efficacy of a multidisciplinary team-approach and the usefulness of the OOPS technique in prenatally diagnosed cervical masses. It emphasizes the extraordinary characteristics of this case, mainly the development of a third space phenomenon and the unusual surgical findings.

Cesarean Section↗
PubMed2002

Unaided speech in tube-free tracheostomy: The supplementary sling procedure.

OBJECTIVE: In some patients after tube-free tracheostomy, air escape hinders voice optimization. Our objective was to determine whether a supplementary sling procedure could reduce air escape and improve unaided speech and cough in these patients. STUDY DESIGN AND SETTING: From September 1998 through June 2001, 12 patients underwent supplementary sling procedures at the Cleveland Clinic. After surgery, stoma constriction and voice production were assessed. RESULTS: Fifteen procedures were performed in 12 patients. Two patients required revision procedures. All 9 patients with sufficient follow-up have markedly improved stoma constriction and speech production. Three patients with less than 3 months' follow-up already show early improvement. CONCLUSION: The supplementary sling procedure effectively reduces air escape and helps unaided speech and cough in patients with tube-free tracheostomata. SIGNIFICANCE: As more patients undergo tube-free tracheostomy, the pool of patients who might benefit from a sling procedure will grow. Indications might extend to postlaryngectomy or post-laryngeal transplant patients.

Adult↗
PubMed2002

Nonsurgical management of parapharyngeal space infections: a prospective study.

OBJECTIVE/HYPOTHESIS: Parapharyngeal infections, which can potentially cause life-threatening complications, may, in certain cases, be treated conservatively with no need for surgical drainage. A review of the literature reveals that the most recommended treatment of parapharyngeal infection is surgical drainage combined with intravenous antibiotic therapy. Several retrospective reports recommend conservative treatment with no surgical drainage. STUDY DESIGN: Prospective, nonrandomized. METHODS: A prospective study was performed on all patients with an infection limited to the parapharyngeal space. RESULTS: Twelve patients presented with clinical and radiological diagnosis of parapharyngeal infection during a 5-year period. Five patients showed obvious presence of pus in other spaces and therefore were excluded. Seven patients with no gross extension into other spaces and with no respiratory distress or septic shock were treated with intravenous amoxicillinclavulanic acid for 9 to 14 days (average period, 11 days). All patients except one were children. All were cured with conservative management, and no surgical drainage was needed. None had any complications. CONCLUSION: Our results confirm the effectiveness of nonsurgical treatment of infections limited to the parapharyngeal space, at least in the pediatric population.

Adult↗