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Biomedical subjects

T L Tewfik

Publications and source records attributed to T L Tewfik.

At least 37 records · Page 2Linked to original sources
PubMed1997

Otolaryngologic manifestations of neurofibromatosis in children.

OBJECTIVE: Neurofibromatosis (NF) is a genetic disease with a wide variety of clinical manifestations. Eight patients with otolaryngologic manifestations of NF are presented. This represents 4.9% of all NF patients currently registered at the NF clinic at the Montreal Children's Hospital. METHODS: Clinical manifestations are divided into cosmetic and functional categorizations. RESULTS: Five patients presented with cosmetic deformities, the most common being an enlarging facial mass. Three patients presented with functional impairments, the most common being hearing loss and airway obstruction. Radiologic findings include the presence of plexiform neurofibromas and airway obstruction. Management was individualized to improve cosmesis and/or function. In the literature, the incidence of head and neck manifestations in patients with NF varies between 14% and 37%. Cosmetic lesions include pigmentary changes (café-au-lait spots), prominent neurofibromas, and osseous lesions. Functional deficits include hearing loss, speech and voice abnormalities, airway obstruction, dysphagia, facial paresis, lip incompetence, and impaired mastication. Diagnosis of NF-1 (classic von Recklinghausen's disease) and NF-2 (bilateral acoustic schwannomas) can be made using specific criteria. Management of patients with NF is individualized depending on the cosmetic deformity, functional impairment, and/or malignant potential of tumours. NF is progressive and has no cure. Prognosis depends on individual clinical manifestations, surgical resectability, and the potential for sarcomatous degeneration. CONCLUSION: This study provides a unique classification of the otolaryngologic findings in NF, giving the otolaryngologist an operable framework for diagnosis, treatment and prognosis.

Airway Obstruction↗
PubMed1994

Outpatient tonsillectomy and adenoidectomy: complications and recommendations.

An example of cost-effective alternatives in medical care is the increasing use of out-patient surgery for those children requiring tonsillectomy, or tonsillectomy with adenoidectomy rather than an in-patient procedure. Two studies were carried out to answer questions about the complications, in addition to post-operative hemorrhage, and also the questions about the parental views and concerns relating to providing at-home care for their children following surgery. A triad, including recent history of upper airway infection, knife dissection technique, and increased intra-operative blood loss of 100 ml or more should be used to help identify the risk of post-operative hemorrhage.

Adenoidectomy↗
PubMed1994

Viral implications in the formation of multicentric inverting papilloma.

There is growing information to support a viral etiology in inverting papilloma formation. Evidence for this hypothesis comes from clinical findings of multicentricity, high recurrence rates, identification of human papilloma virus (HPV), and the presence of viral-like particles within the tumour tissue. Four cases of multicentric inverting papilloma are presented. In one patient, a squamous papilloma (wart) of the nasal vestibule recurred as an inverting papilloma. Another patient also had a cutaneous wart on the right index finger. These cases and others from the literature are discussed with respect to a viral mode of transmission.

Adolescent↗
PubMed1993

Ambulatory tonsillectomy and adenoidectomy: complications and associated factors.

This is a case-control study of over 500 cases of tonsillectomy and adenotonsillectomy performed at the Montreal Children's Hospital over a 10-month period. Demographics of patient population and selection criteria for out-patient procedure are presented. The hot (cautery) and cold (knife) dissection techniques are compared. Complications including intraoperative and postoperative hemorrhage are presented. The recognition of aerodigestive tract complications necessitating re-admission or emergency room management cannot be over emphasized. Recent history of upper airway infection (UAI) was noted to be associated with postoperative aerodigestive tract complications. The triad of UAI, knife dissection technique and increased intraoperative bleeding was found to be associated clinically and statistically with primary postoperative hemorrhage.

Adenoidectomy↗
PubMed1993

Cogan's syndrome: a review of otologic management and 10-year follow-up of a pediatric case.

Although first characterized over 45 years ago Cogan's syndrome still remains a rare disease, with a high incidence of poor outcome. Experience with a case of Cogan's syndrome over a 10-year period is presented. The fluctuating clinical evolution and laboratory findings over this period are depicted, starting from presentation at age 10. The response to treatment, as revealed by audiograms, is traced. The literature is reviewed with regard to treatments that have been proposed. In those cases where a sustained follow-up is available, the success of the therapy on the vestibuloauditory system is evaluated. Although some patients have a positive response to steroids, the prognosis for hearing remains poor. The ability of steroids to change the prognosis for hearing loss is not yet established, but warrants further clinical trial.

Child↗
PubMed1992

Metastatic neuroblastoma presenting as a mandibular mass.

Neuroblastoma is the third most common type of cancer seen in children, after leukemia and tumours of the central nervous system. Although bony metastasis to the skull and the orbits has been well described, metastasis to the mandible is exceptional; 32 cases have been reported. Two more are presented here, along with a short review of the topic emphasizing the radiographic features and the differential diagnosis.

Abdominal Neoplasms↗
PubMed1991

Kaposi's sarcoma of the intra-parotid lymph nodes in AIDS.

Kaposi's sarcoma is the most frequent malignancy associated with AIDS. The occurrence of Kaposi's sarcoma in the parotid region is extremely rare. In this publication we present a case of a 47-year-old male patient who developed a swelling of the left parotid tail that proved to be Kaposi's sarcoma of an intra parotid lymph node. A discussion of the etiological factors, clinical staging and management of KS, as well as the differential diagnosis of the parotid enlargement in AIDS patients, is presented.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Aneurysmal bone cyst of the mandible.

The aneurysmal bone cyst (ABC) is a benign, solitary lesion of bone which is most commonly found in the long bones and vertebral column. Its occurrence in the mandible is uncommon. Because of its infrequent appearance, the ABC may be mistaken for neoplastic lesions. In the past, management has consisted of curettage, cryotherapy and local resection. In this publication we present a case of ABC of the mandible. We include a review of the literature, a discussion of the etiology, pathogenesis and management of this interesting lesion.

Adolescent↗
PubMed1990

Hodgkin's disease in the nasopharynx.

Nasal obstruction due to adenoid hypertrophy is extremely common in the pediatric age group and is generally successfully treated by adenoidectomy. The case report of the incidental finding of Hodgkin's disease in an adenoidectomy specimen will be presented. Overall, for all age groups and stages of disease, fewer than 75 cases of Hodgkin's disease with nasopharyngeal involvement have been reported in the world literature. Further, fewer than 15 cases had isolated primary involvement. Although unusual, the occurrence of primary adenoidal Hodgkin's disease in our patient supports the submission of adenoidal tissue for micropathological examination when a relatively large amount of tissue is found at the time of surgery.

Adenoids↗
PubMed1989

Pitfall-to-avoid pharyngeal opacities caused by bismuth subgallate.

Bismuth subgallate is used occasionally as a hemostatic agent for packing the adenoidal and tonsillar beds after an adenotonsillectomy. Containing a heavy metal, it is relatively insoluble and poorly absorbed. It produces faint opacities on plain radiographs and these may mimic a foreign body or pharyngeal calcification. We report a 13-year-old girl with linear radiopacities in the nasopharynx and in the palatine tonsillar bed. Careful and complete clinical information pinpointed the exact (iatrogenic) cause of these radiodensities.

Adolescent↗
PubMed1989

[Deafness in juvenile relapsing polychondritis. A case report].

Relapsing polychondritis is an autoimmune disease that affects all body cartilages. The disease may also involve the audio-vestibular system, usually bilaterally. Most of the reported cases were adults 20 years old or more. This is a case report of a 12-year-old girl with unilateral sensorineural hearing loss, and a review of the literature.

Child↗
PubMed1988

Post-tonsillectomy and adenoidectomy hemorrhage.

This is a retrospective review of 6842 tonsillectomies and adenoidectomies performed over a seven-year period at the Montreal Children's Hospital. The total incidence of postoperative bleeding was 2.5%. The incidence of primary post-tonsillectomy hemorrhage was 1.0%, with 78% of these children having developed bleeding within 12 hours of surgery. The overall incidence of secondary post-tonsillectomy hemorrhage was 1.2%. Twenty-nine percent of children with primary hemorrhage required a second general anesthetic, and 40% required blood component transfusion. Eight percent of children with secondary hemorrhage required a second general anesthetic and 24% received transfusions. Based on these findings, primary and secondary hemorrhage can be classified further into major and minor. The criteria for a major post-tonsillectomy hemorrhage are: requirements of a general anesthetic to control and repair the bleeding, or blood loss that is sufficient to require blood component transfusion therapy. The relevance of these findings with regard to outpatient adenotonsillectomies is discussed.

Adenoidectomy↗
PubMed1987

Inverted papillomas of the nose and paranasal sinuses in children.

Inverted papillomas are uncommon lesions in the nose and paranasal sinuses, especially in the pediatric age group. We report the occurrence of one case in a 13-year-old Chinese female. Review of the literature and conclusions about management of these lesions in children are provided.

Adolescent↗
PubMed1986

Observations on the prevalence of ear disease in the Inuit and Cree Indian school population of Kuujjuaraapik.

In the last twenty years it has been recognized that hearing loss as the result of middle ear infection and/or noise exposure is a major problem among Canadian Inuit. In the past ten years in the Eastern Canadian Arctic attempts have been made to alleviate the problem and physicians, audiologists and educators have been involved in treatment, training programs and research with varying degrees of success. In the last few years the Quebec Inuit have become more aware of these problems and have asked for assistance. Whatever evolves, Inuit co-operation and advice is essential; their cultural identity must be respected if any project is to be successful. In February, 1984, a program outline working paper entitled "Program for Combatting Hearing Disorders in the Inuit Population of Nouveau Quebec" was circulated by Project Nord-Laval University. The goal of the program was "to ensure the integrity of hearing for the Inuit by preventing hearing loss, identifying hearing loss and minimizing the effects of hearing loss." In October, 1984 a Pilot Project involving the school population at Kuujjuaraapik was carried out involving personnel from the Project Nord-Laval University, the Department of Otolaryngology and the School of Human Communication Disorders-McGill University.

Adolescent↗