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Biomedical subjects

Y Finkelstein

Publications and source records attributed to Y Finkelstein.

At least 109 records · Page 6Linked to original sources

True malignant mixed tumour of the parotid gland.

Carcinoma ex-pleomorphic adenoma is an uncommon tumour of the parotid gland. True malignant mixed tumours of the parotid are rare and we could find only 14 such cases reported. A case of a 76-year-old man diagnosed as suffering from this entity is presented. The diagnosis was based on a series of immunohistochemical studies demonstrating the existence of two separate sarcomatous and carcinomatous elements. The clinical and histological data are presented and the literature is reviewed.

Adenoma, Pleomorphic↗

Reduction of salivary flow with transdermal scopolamine: a four-year experience.

Scopoderm transdermal therapeutic system (TTS) is applied to prevent nausea and vomiting associated with motion sickness. Dry mouth is the most common side effect, appearing in up to two thirds of the patients treated. We have used this side effect to the benefit of patients with sialorrhea or with difficulties swallowing normally secreted amounts of saliva. More than 100 patients with tumors of the aerodigestive tract before and after surgery, and patients after parotidectomies, after tracheotomies, with peritonsillar abscesses, tonsillitis and pharyngitis, and neurologic disorders were thus treated. Reduced secretion of saliva was seen in 50% to 100% of the treatment groups. Other side effects were minimal and we recommend the use of scopoderm TTS for reduction of salivary flow.

Administration, Cutaneous↗

Ozena revisited.

Primary atrophic rhinitis or ozena is a chronic nasal disease characterized by progressive atrophy of the nasal mucosa and underlying bone, accompanied by the formation of foul smelling, thick, dry crusts in the greatly enlarged nasal cavities. Although the incidence of ozena is greatly diminished in the western world, it is still encountered rarely and merits the attention of the ENT specialist. Hereditary, infectious, developmental, endocrine and nutritional factors have been implicated but the etiology of ozena still remains enigmatic. Numerous surgical and non-surgical methods have been advocated for treatment of ozena. We review our experience with 17 ozena patients in the past 20 years and discuss different modes of treatment. The relevant literature is reviewed.

Adolescent↗

Tuberculosis of a periglandular lymphnode presenting as a parotid tumor.

The presentation of tuberculosis as isolated cervical adenopathy is not a common entity. The presentation of this disease as a parotid mass has rarely been reported. In most instances, direct parenchymal involvement exists, although involvement of intraglandular lymphnodes has also been reported. In most cases, an initial misdiagnosis of a parotid tumor, usually a pleomorphic adenoma, was made. We report a case of a 57-year-old patient with a left parotid mass of two years' duration. The patient was referred because of the development of firm, nontender, ipsilateral cervical adenopathy, suggesting possible malignancy. The course of the disease, diagnosis, and treatment are reported. The relevant literature is reviewed.

Diagnosis, Differential↗

Levator veli palatini muscle and eustachian tube function.

Thirty previously unoperated patients with submucous cleft palate, occult submucous cleft palate, and unilateral congenital paralysis of the levator veli palatini muscle were examined. All patients were subjected to a comprehensive otoscopic, endoscopic, audiologic, and tympanometric evaluation. A correlation was made between levator veli palatini muscle anomalies, eustachian tube orifice anomalies, and middle ear ventilation and disorders. Normal middle ear ventilation was found in 23 patients. Negative middle ear pressure that consequently normalized following treatment of coexisting sinusitis was found in 3 patients. Only in 4 patients was chronic middle ear disease found. In one of them, middle ear effusion disappeared following successful treatment of sinusitis. Our conclusion is that the levator veli palatini muscle has no significant function in the opening mechanism of the eustachian tube and must be considered as a velopharyngeal valve muscle only.

Adolescent↗

Otolaryngic examination of the sport scuba diver.

Diving is a sport presenting unique environmental and physiological hazards to its participants. Despite this, scuba diving is an enjoyable and safe hobby, with an estimated rate of 250,000 new divers certified each year. The ears, nose, and paranasal sinuses are the source of the most common problems in divers. Proper otorhinolaryngic medical examination is vital in the certifying of diving candidates and in routine examinations of active scuba divers. Most authorities agree on major guidelines applicable in ENT examination, although some points are a matter of controversy. Based on the major sources on the subject and our own experience, we have listed disqualifying disorders and relative or temporary contraindications for sport scuba diving. Although there are no regulations specifying medical standards for sport divers in the United States, we have tried to provide guidelines for the general practitioner and ENT specialist engaging in an otolaryngic medical examination of a sport scuba diver.

Clinical Protocols↗

Use of a Braunula for maxillary sinus irrigation.

Puncture and lavage of the maxillary sinuses is a common procedure in ENT practice. Repeated irrigations are required in chronic sinusitis refractory to treatment. In our department we use a No. 14 gauge Braunula for such cases. Over 100 patients have been treated over the past two years with no significant complications. This device is inexpensive, sterile, safe and easy to use and we recommend its use for patients with chronic maxillary sinusitis requiring repeated irrigations.

Catheterization↗

Otitis media with effusion as a presenting symptom of chronic sinusitis.

Otitis media with effusion was the presenting symptom in 23 per cent of patients suffering from chronic sinusitis. The inter-relationship between chronic sinusitis and otitis media with effusion was studied in 29 patients. Endoscopic evaluation of intranasal structures including sinus ostia and Eustachian tube orifices was carried out. We further suggest that otitis media with effusion is not a separate entity but a presentation of sinus disease, predominantly of the ethmoid system. Patients with otitis media with effusion should be evaluated for sinusitis and vice versa. The value of careful nasendoscopy is demonstrated.

Adolescent↗

Acoustic trauma-induced Meniere's syndrome.

Eight male patients suffering from Menière's syndrome are presented. All patients sustained sudden or prolonged exposure to severe noise levels and suffer from acoustic trauma. The incidence of Menière's syndrome in our group of patients is significantly higher than in series reported in the normal population. Our presentation supports the implication of acoustic trauma as a possible cause of Menière's syndrome.

Adult↗

Pharyngeal fistulas in postoperative hypothyroid patients.

Hypothyroidism is a well-recognized complication of combined treatment for head and neck cancer. We discuss four patients who developed pharyngeal fistulas after total laryngectomy and preoperative (one patient) or postoperative (three patients) radiation therapy. The fistulas were refractory to conservative and surgical repair. Once the existence of hypothyroidism was established, immediate substitution therapy resulted in rapid healing of the fistulas and marked improvement of the patients' general condition. Few clinical reports exist on postoperative hypothyroidism and wound healing complications. Experimental work shows delay and impairment of wound healing in hypothyroid animals as opposed to hyperthyroid ones, in which wound healing was accelerated. Suspicion is warranted in patients after treatment for head and neck cancer when they exhibit even minimal symptoms of hypothyroidism or develop postoperative complications refractory to conservative treatment.

Aged↗

Mycobacterium tuberculosis cervical adenitis. Diagnosis and management.

Cervical adenopathy as the sole presentation of tuberculosis is seen infrequently in the pediatric age group. Despite modern treatment and public health measures, tuberculous cervical adenitis persists, and its prompt diagnosis and treatment are important from both a clinical and preventive health perspective. The authors report five cases of children with ages ranging from 8 to 17 years, in whom cervical adenitis was the only presentation of infection with Mycobacterium tuberculosis. The clinical presentation and methods of diagnosis and treatment are described, and the difficulty of differentiation between infections with M. tuberculosis and non-tuberculous mycobacterial infections is stressed. Tuberculous cervical adenitis should be considered in cases of an elusive diagnosis of a cervical mass in the pediatric patient.

Adolescent↗