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Biomedical subjects

S D Schaefer

Publications and source records attributed to S D Schaefer.

89 records · Page 5Linked to original sources
PubMed1980

The diagnosis of CSF rhinorrhea by metrizamide CT scanning.

A case of cerebrospinal fluid rhinorrhea is presented in which routine diagnostic evaluation failed to disclose the site of leakage. Computerized tomography (CT) scanning with metrizamide, a nonionic contrast medium, provided not only documentation of the leak but also demonstrated the actual sinus involved. Metrizamide cisternography with CT scanning is a valuable technique in the evaluation of CSF rhinorrhea. It may only be used when an active leak is present. The patient described in this report lost several drops of CSF from the nose per minute in the face-down position. Neurotoxicity may be avoided by routine pre-examination medication with valium or phenobarbital. Mixing of the contrast agent with CSF is diminished by injecting in the subarachnoid space at C1-C2. The methods used in this examination and their indications are described, and the literature concerning metrizamide toxicity and pharmacologic properties reviewed.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1980

Epidermoid carcinoma of the nasal vestibule: current treatment evaluation.

Twelve cases of epidermoid carcinoma of the nasal vestibule with a median follow-up of three years were reviewed to evaluate effectiveness of current treatment modalities. Patients were initially treated by surgery, irradiation, or a combination of both therapies. The authors conclude 1. epidermoid carcinoma of the nasal vestibule is an aggressive disease; 2. once metastases have occurred, they are poorly controlled by surgery and/or irradiation; and 3. initial therapy should be directed to both control of the primary and prevention of distant metastases.

Aged↗
PubMed1979

Bilateral longitudinal temporal bone fractures: a retrospective review of seventeen cases.

The types of temporal bone fractures, longitudinal and transverse, are reviewed. All cases of bilateral temporal bone fractures at Parkland Memorial Hospital in Dallas over a 10-year period from 1968 to 1978 are reivewed and discussed by the authors. One hundred sixty patients with the diagnosis of base of skull fractures were studied. Fifty-nine of these were temporal bone fractures and 17 of the 59 were bilateral. Of all the base of skull fractures, 10% were bilateral temporal bone fractures and 29% of all temporal bone fractures were bilateral. For each case the method of injury, the extent of damage to hearing and facial nerve function, presence of CSF otorrhea, X-ray findings, and additional complications are summarized and the results discussed. The operative findings of facial nerve decompressions are carefully reviewed. The authors' method of caring for temporal bone fractures is presented.

Facial Paralysis↗
PubMed1979

Cervical osteomyelitis complicating transpharyngeal gunshot wounds to the neck.

Four cases of cervical osteomyelitis complicating transpharyngeal gunshot wounds to the neck are discussed. Thorough debridement of bone and soft tissue, adequate drainage, broad-spectrum antibiotics, and rigid immobilization of the cervical spine are essential for the successful treatment of this complication. Inadequate or delayed treatment may result in prolonged hospitalization, the need for multiple surgical procedures, and possible neurologic deficits.

Adolescent↗
PubMed1978

Thyroid surgery: surgical and metabolic causes of hypocalcemia.

Patients undergoing radical surgical treatment of head and neck neoplasms often are seen with a history of cirrhotic liver disease, electrolyte abnormalities, and other stigma of chronic disease. Despite skillful thyroid surgical technique performed as an isolated procedure or in combination with other procedures such as laryngectomy, hypocalcemia can occur. Common causes of lowered serum calcium levels secondary to removal of parathyroid glands, blood transfusions, hypoalbuminemia, gastrointestinal malabsorption, and renal insufficiency are well known. Less well known is the recently elucidated role of dependence of calcium metabolism on magnesium. Recently, it has been well documented that alcoholism directly lowers serum magnesium levels in both human and animal models without prior liver disease or malabsorption. The fact that three mechanisms are needed to explain calcium homeostasis implies that the magnesium-calcium interdependence is not clearly understood.

Calcium↗
PubMed1978

Osteosarcoma of the soft tissue of the larynx: report of a case with light and electron microscopic studies.

A case of osteosarcoma arising in the soft tissue of the larynx in an elderly man is presented with light and electron microscopic documentation. The patient developed chronic hoarseness and a recurring polypoid laryngeal tumor, causing acute airway obstruction. He was treated by total laryngectomy, but he died with multiple pulmonary metastases within three months of laryngectomy. This is the third (or possibly fourth) recorded case of osteosarcoma arising in the soft tissues of the larynx, and the previous cases were clinically and pathologically similar to this one. The prognosis of sarcoma of the larynx is poor but may be improved with early recognition and adequate surgical excision.

Aged↗
PubMedDate not supplied

Computed tomographic evaluation of regional lymph node involvement in cancer of the oral cavity and oropharynx.

To evaluate the efficacy of computed tomography (CT) in the identification of metastatic cervical node involvement from cancer of the oral cavity and oropharynx, 61 consecutive, previously untreated patients with T2 or greater squamous cell carcinoma of these sites were studies prospectively by CT, followed within 1 month by surgery to the primary and neck as initial treatment. The CT scan of each patient was evaluated according to the location, size, and appearance of visible nodes, and each feature was correlated with the histopathologic findings of all 83 neck specimens. A significant relationship was found between CT findings (node size, node appearance, and multiplicity of nodes) and the pathologic status of the neck using Chi-square contingency table analysis (overall chi 2 = 30.928, p less than 0.001). This data supports the role of CT in the evaluation of patients with cancer of these sites.

Adult↗
PubMedDate not supplied

Cricoarytenoid subluxation, computed tomography, and electromyography findings.

A case of cricoarytenoid subluxation secondary to endotracheal intubation and documented by computed tomography (CT) and electromyography (EMG) is reported. Successful endoscopic reduction of the displaced arytenoid is confirmed by CT. The normal anatomy and physiology of the cricoarytenoid joint is presented and the literature regarding this rarely reported injury is reviewed. Based on this review and the case reported, a treatment plan is proposed.

Arytenoid Cartilage↗
PubMedDate not supplied

Auditory brainstem response abnormalities in adductor spasmodic dysphonia.

Six patients with adductor spasmodic dysphonia were evaluated for evidence of brainstem dysfunction using the auditory brainstem response (ABR). In four, abnormally large increments in wave V latencies were found at high stimulus repetition rates. Latency increments exceeded three standard deviations above the mean in a normative adult population. A fifth patient had the prolonged interpeak latencies described previously by other investigators. In five of six patients the capacity of the auditory brainstem to conduct impulses was compromised. These results suggest a central nervous system abnormality in adductor spasmodic dysphonia.

Adult↗
PubMedDate not supplied

A calcareous concretion in the posterior semicircular duct of a human labyrinth.

Temporal bones were acquired four hours post mortem from a 67-year-old cancer patient. During dissection of the left vestibular labyrinth, a glistening white, spherical concretion was found in the posterior semicircular duct near the ampulla. The object was subsequently studied by light and scanning electron microscopy, x-ray diffraction, and x-ray energy dispersive elemental analysis. It was composed of four concentric layers: an outer zone of tabular vaterite crystals, a colorless intermediate zone of spherulitic octacalcium phosphate (OCP), and a cloudy core with inner and outer zones both composed of OCP. Examination of the vestibular receptor organs revealed severe loss of hair cells on all three cristae. Very few otoconia were present in the utricle, although the gelatinous layer of the otoconial membrane was intact on the macular surface. During the year preceding his death, the patient had received 800 mg of the potentially ototoxic drug cis-platinum. The concretion described in this report was, however, probably connected with age-related degeneration rather than with any effect of the drug.

Aged↗
PubMedDate not supplied

Monophasic extraskeletal mandibular fixation in head and neck surgery.

Stabilization, reconstruction, and rehabilitation of certain mandibular fractures or continuity defects may be facilitated by external skeletal fixation. The utilization of a convenient and inexpensive monophasic extraskeletal fixation appliance in select instances of mandibular trauma or head and neck surgery is described herein and illustrated with case reports.

Adult↗
PubMedDate not supplied

Brainstem conduction abnormalities in spasmodic dysphonia.

Twelve spasmodic dysphonia patients were evaluated by three different auditory brainstem response parameters; 75% were abnormal. Three of the 12 had prolonged wave I-V interpeak latency. Seven had pathologic wave V latency shifts at a high stimulus rate. Amplitude ratios were normal for all subjects. The authors hypothesize that spasmodic dysphonia is a disorder of variable cranial nerve symptom presentations, and offer several possible models to account for its sporadic representation in the nervous system.

Adult↗
PubMedDate not supplied

Computed tomography in the assessment of mandibular invasion by intraoral carcinoma.

A critical factor in the pretreatment evaluation of patients with carcinoma of the oral cavity or oropharynx is the presence or absence of bone invasion. A prospective study was performed to compare the sensitivity and specificity of plain radiographs and computed tomography in detecting mandibular invasion by cancer arising in these sites. Forty-three consecutive patients with previously untreated oral cavity or oropharyngeal carcinoma were evaluated preoperatively by intraoral radiographs (dental occlusal views and panoramic radiographs) and CT, and the results were compared with postoperative pathologic findings. Of the 11 cases in which pathologic examination confirmed bone invasion, conventional x-ray films were positive in seven (63.6%). Computed tomography confirmed bone invasion in all 11 (100%) of these patients. In addition, the CT scan was more specific than conventional x-ray films in detecting bone invasion. Based on the findings in this study, we strongly recommend CT as the only radiographic study necessary to evaluate intraoral carcinoma prior to treatment.

Aged↗
PubMedDate not supplied

Asymptomatic laryngocele: incidence and association with laryngeal cancer.

Since laryngoceles are usually asymptomatic, their incidence is probably higher than the literature suggests. With the advent of computed tomography, the incidence and significance of the asymptomatic laryngocele in a general head and neck practice can be addressed. To this end, 304 consecutive patients with a variety of otolaryngic diagnoses were studied prospectively by computed tomography of the neck from January 1983 to February 1985. Thirty-eight (12.5%) of the patients had asymptomatic laryngoceles, defined as air-containing structures in the supraglottic region extending more than 5 mm above the superior border of the thyroid cartilage during normal breathing. The incidence of laryngoceles associated with laryngeal cancer (29%) was higher than that for laryngoceles associated with other diseases (9%). No patient with an asymptomatic laryngocele not associated with laryngeal cancer showed evidence of a subsequent laryngeal neoplasm during close follow-up of 10 to 36 months.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Blunt and penetrating laryngeal trauma: a 13-year review.

A 13-year retrospective review of 53 patients with laryngeal trauma seen between 1965 and 1975 at the University of Texas Health Science Center at Dallas affiliated hospitals is presented. Patient management fell into four groups: observation following direct laryngoscopic examination or observation alone (7 patients), direct laryngoscopic examination and tracheostomy (5 patients), open reduction of fractures without stenting (14 patients), and open reduction of fractures with stenting (27 patients). These cases were analyzed according to initial signs and symptoms, duration between time of injury and surgery as pertains to success of management, indications for open reduction of laryngeal fractures, and associated injuries.

Humans↗
PubMedDate not supplied

Epidural mucopyocele: diagnosis and management.

Mucopyoceles of the frontoethmoid sinuses occurring as an epidural mass are uncommon. Four patients with this condition have been managed over the last eight years by the authors. Two patients had early recurrence of their disease following carefully performed ablation and frontal craniectomy. Marsupialization, or permanently draining the ablated frontal sinus cavity into the nose, was the initial treatment of the other two patients, and subsequently the therapy of choice for all patients in this series.

Adult↗