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Biomedical subjects

T A Tami

Publications and source records attributed to T A Tami.

48 records · Page 3Linked to original sources
PubMed1987

Cervical osteomyelitis. An unusual complication of tonsillectomy.

Tonsillectomy is one of the most common operations performed by the otolaryngologist. Deep-neck infections are among the possible complications associated with this procedure. We encountered a case of osteomyelitis of the cervical spine occurring subsequent to an otherwise uncomplicated tonsillectomy. Although never previously reported with tonsillectomy to our knowledge, cervical osteomyelitis has been associated with other procedures and infections of the head, neck, and maxillofacial regions. Mechanisms that might explain this occurrence include direct extension via fascial planes, direct venous and lymphatic spread, and hematogenous dissemination from the contaminated surgical site. Treatment consisted of drainage and débridement of the infection, cervical immobilization, and long-term antibiotic administration. Healing was complete and cervical mobility and stability were normal at three months. Early recognition of this unusual complication of tonsillectomy is imperative to avoid potential neurologic sequelae.

Adult↗
PubMed1987

Post-tonsillectomy bleeding: an evaluation of risk factors.

While tonsillectomy is usually a safe operation, it is always accompanied by the risk of immediate postoperative bleeding. Despite continued efforts to eliminate this problem, it remains a persistent risk. In reviewing 775 consecutive cases of tonsillectomy, immediate postoperative bleeding occurred in 21 (2.7%). Diagnostic, demographic, hematologic, hemodynamic and surgical management factors were evaluated. The role of local anesthesia for tonsillectomy was also examined. Postoperative bleeders were more likely to have abnormal preoperative clotting studies, greater elevations of their mean postoperative blood pressures, and unusual surgical indications. Local anesthetic cases were shorter, had less intraoperative bleeding and were not associated with greater postoperative bleeding. We conclude that local anesthesia is safe and efficient and that identifiable factors are associated with primary post-tonsillectomy bleeding. An awareness of these factors can help identify potential postoperative bleeders.

Adolescent↗
PubMed1986

Pulmonary edema and acute upper airway obstruction.

Pulmonary edema following the relief of acute upper airway obstruction is unusual and unpredictable. The cause is usually attributed to pulmonary and hemodynamic changes resulting from high negative intrathoracic pressures during obstructed respiration. The incidence of this problem is not known. Why pulmonary edema develops in only certain patients is also unclear. We reviewed the records of 27 consecutive adult patients admitted and treated for acute upper airway obstruction. Three of 27 (11%) developed pulmonary edema. Age, sex, diagnosis, duration of obstruction, history of cardiopulmonary disease, and perioperative fluid administration were evaluated. No differences were noted between those who did and those who did not develop pulmonary edema. Pulmonary edema following acute upper airway obstruction appears to be more common than is generally appreciated, however, no specific factors seem related to its occurrence.

Adult↗
PubMed1985

Effects of noise exposure and hypercholesterolemia on auditory function in the New Zealand white rabbit.

An association between hypercholesterolemia and high-frequency hearing loss has been suggested previously. Most data have been epidemiologic, and only recently have experimental studies appeared supporting this observed association. It is unclear whether this hearing loss is related solely to hypercholesterolemia or if it is a consequence of cholesterol-induced vascular changes. The New Zealand White rabbit was used to study the auditory effects of noise, hypercholesterolemia, and the combination of both. Auditory function was evaluated with far-field monitoring of click-evoked auditory brain stem responses by comparing latency/intensity functions and absolute click-evoked thresholds. Hypercholesterolemia was maintained for only 3 weeks, theoretically eliminating atherosclerotic vascular changes as a mechanism contributing to observed changes. Auditory function was unchanged after 3 weeks of hypercholesterolemia. Also, the changes observed after noise exposure were comparable between the normal and the hypercholesterolemic groups. We conclude that if hypercholesterolemia contributes to high-frequency hearing loss, the pathophysiology is related to cholesterol-induced vascular changes, not solely to hypercholesterolemia.

Animals↗
PubMed1984

Eikenella corrodens. An emerging pathogen in head and neck infections.

Eikenella corrodens is a gram-negative, facultative anaerobe that exists as part of the normal oral flora. Its role as a pathogen in human infection has been disputed, but recently its pathogenic potential has been increasingly recognized. A review of the literature reveals the emergence of this organism as a pathogen in human infection. Specific microbiologic characteristics of this organism make it difficult to isolate and evaluate for antibiotic sensitivities. Infections produced by this bacteria are characteristically indolent in nature and are usually associated with oral contamination. Appropriate antibiotic therapy utilizes ampicillin or penicillin. Tetracycline is the drug of choice in the penicillin-allergic patient. Clindamycin resistance is a universal feature. A greater awareness of the pathogenic potential of E corrodens is essential for appropriate recognition and treatment.

Administration, Oral↗
PubMedDate not supplied

Thyroid dysfunction after radiation therapy in head and neck cancer patients.

INTRODUCTION: The reported incidence of hypothyroidism following surgery and/or radiation therapy for head and neck cancer varies widely. Most patients undergo thyroid lobectomy during laryngectomy. Standard radiation treatment portals often include the thyroid gland. The insidious development of hypothyroidism may be misdiagnosed. This study examines the incidence of thyroid dysfunction in the setting of head and neck cancer therapy. MATERIALS AND METHODS: Thyroid function tests were performed on 100 consecutive patients treated in the head and neck tumor clinic. Statistical inferences on proportions were made using chi-square analysis. RESULTS: Therapy included surgery only (10 patients), radiation therapy only (28 patients), and combined therapy (62 patients). These patients experienced thyroid dysfunction in 0%, 29%, and 45% of individuals respectively. These differences were statistically significant (P < .05). The highest rate of dysfunction (69%) was associated with patients undergoing laryngectomy and radiation therapy. When laryngectomy was not performed, thyroid dysfunction occurred in 28%. CONCLUSION: The likelihood of thyroid dysfunction after radiation therapy is high particularly when combined with surgery in which thyroid lobectomy is performed and the contralateral lobe is potentially devascularized. These results suggest that radiation therapy is a primary factor in alteration of thyroid function. We recommend that routine thyroid function testing be part of follow-up of all head and neck cancer patients.

Chi-Square Distribution↗
PubMedDate not supplied

The effect of water exposure after tympanostomy tube insertion.

INTRODUCTION: Unprotected water exposure as a cause of otorrhea in patients with tympanostomy tubes remains controversial. Although most otolaryngologists continue to recommend either the avoidance of swimming or the use of water precautions during swimming, evidence indicates that the infection rate may not be affected by this practice. This study prospectively evaluates the possible role of unprotected water exposure in the occurrence of post-tympanostomy-tube otorrhea. MATERIALS AND METHODS: Two hundred twelve consecutive patients undergoing tympanostomy tube placement were randomized into swimming and nonswimming groups. No special precautions (eg, ear plugs, canal occlusion, antibiotic drugs) were used in either group. This incidence of otorrhea was then compared between these groups. RESULTS: One-year follow-up was obtained in 107 patients. There was no significant difference in the incidence of otorrhea or the number of otorrhea episodes between the two groups. CONCLUSIONS: Swimming is not contraindicated in patients with tympanostomy tubes, and water precautions do not decrease the incidence of otorrhea.

Anti-Bacterial Agents↗
PubMedDate not supplied

Spontaneous thrombosis of the internal jugular vein.

The internal jugular vein is an uncommon site of deep venous thrombosis. Infection, prolonged central venous catheterization, and trauma are the usual causes of this condition. We present an unusual case of spontaneous thrombosis of the internal jugular vein. The evaluation of this case included a search for possible anatomic, hematologic, and oncologic conditions which could predispose to hypercoagulability and thrombosis. Anticoagulation therapy resulted in complete resolution of thrombosis and subsequent recanalization of the internal jugular vein.

Aged↗
PubMedDate not supplied

Nasal and sinus manifestations of sarcoidosis.

Nasal and sinus diseases are considered uncommon manifestations of sarcoidosis. We evaluated 159 consecutive patients with sarcoidosis for nasal symptoms. Sixty-three patients (39%) denied any nasal symptoms. Thirty-six patients (23%) had intermittent symptoms that lasted less than three weeks and required continuous intervention with nasal steroids or normal saline. Sixty patients (38%) were treated with nasal steroids and antibiotics for symptoms that lasted more than three weeks. Thirty-three patients (21%) had resolution of their symptoms after treatment with nasal steroids and antibiotics. Twenty-seven patients (17%) had symptoms that were unresponsive to three weeks of oral antibiotics and nasal steroids, and underwent CT scan. Based on the CT results, five patients underwent biopsy, which confirmed sarcoidosis. An additional patient who had a normal CT scan underwent a biopsy that was consistent with sarcoidosis. A retrospective review of 733 sarcoidosis patients was then performed, and an additional 12 patients were identified with biopsy-proven sarcoidosis. All of these patients required long-term therapy with prednisone (14 patients), methotrexate (13 patients), and/or azathioprine (8 patients). Our clinical study reveals a higher incidence of nasal and sinus disease in patients with sarcoidosis than has previously been described, and the recalcitrance of sarcoidosis when there is sinus involvement.

Adult↗