ABSTRACT
Laryngomalacia is the most common cause of stridor in infants. In severe cases, it results in obstructive sleep apnea, cor pulmonale, gastroesophageal reflux, failure to thrive, and pectus excavatum. Our experience with 24 children who underwent laser excision of redundant supraglottic tissue from May 1987 to July 1991 is reviewed. The technique emphasizes preoperative planning with flexible fiberoptic laryngoscopy, apneic anesthetic for the procedure, conservative resection of tissue and the need for complete airway evaluation. In our series, 71% of patients experienced complete resolution of symptoms. Nine of 10 postoperative sleep studies indicated improvement. In 4 patients, collapse developed later in other areas of the supraglottis, resulting in recurrence of stridor several months after the initial procedure, and requiring revision laryngoplasty. In several patients with other significant sites of upper airway obstruction (e.g., tonsils and adenoids, and a tongue base cyst), laryngomalacia became more significant following alleviation of the primary source of airway obstruction. Twelve patients (50%) required additional airway procedures either before or following initial laryngoplasty. Patient selection, sleep study data, and complications are reviewed.
Subject(s)
Laryngeal Diseases/surgery , Larynx/surgery , Laser Therapy , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Laryngeal Diseases/physiopathology , Male , Respiratory Sounds/etiology , Retrospective StudiesABSTRACT
The prognosis of respiratory papillomatosis (RP) in newborns appears to be less favorable than in infants and older children. In this series of four patients who developed symptoms of the disease within the first 6 months of life, the mortality was 100%. In these premature and term newborn infants, endoscopic laser surgery and medical and immunologic therapy were unable to control the growth of RP. Meticulous local removal of the airway lesions is the most reliable form of management.
Subject(s)
Laryngeal Neoplasms/pathology , Neoplasms, Multiple Primary/pathology , Papilloma/pathology , Tracheal Neoplasms/pathology , Diseases in Twins , Female , Glottis/pathology , Humans , Infant , Infant, Low Birth Weight , Infant, Newborn , Infant, Premature , Male , Neoplasm Recurrence, Local , Twins , Vocal Cords/pathologyABSTRACT
Fractures of the parasymphyseal mandible occur in 15% of all cases of mandibular fracture. The experience obtained from 32 consecutive parasymphyseal fractures is outlined. Open reduction and internal fixation was required in patients having severe comminution, a mobile central fragment, or bilateral subcondylar fractures. These circumstances constituted 15% of all parasymphyseal fractures. The techniques utilized have been outlined.
Subject(s)
Fracture Fixation/methods , Mandibular Fractures/therapy , Follow-Up Studies , Fracture Fixation, Internal , Humans , Mandibular Fractures/surgery , Methods , Orthopedic Fixation DevicesABSTRACT
Antibody-dependent cell-mediated cytotoxicity (ADCC) exhibited by peripheral blood leukocytes was used as a criterion for assessing immune competence of groups of noncancerous individuals and of treated and untreated cancer patients. The results show that, as a group, leukocytes of nontreated cancer patients exhibited significantly lower ADCC than that exhibited by leukocytes of noncancerous individuals. However, the ADCC of leukocytes from cancer patients under treatment approximated that of normals. Thus, using ADCC as criterion, the results indicate that as a group, cancer patients under treatment tend to exhibit restored immune competence.
Subject(s)
Antibody-Dependent Cell Cytotoxicity , Neoplasms/immunology , Female , Humans , Male , Neoplasms/therapy , Statistics as TopicABSTRACT
This report deals with a consecutive series of 156 mandibular fractures that were managed during a three-year period. The age and sex incidence are presented and the causative factors of the trauma are discussed. The fractures are classified according to anatomic site and laterality. The majority of the patients were treated with closed reduction techniques and the reasons for open reduction are tabulated. The results and complications of the treatment are enumerated. A conservative technique is described for open reduction of fracture-dislocations of the condylar head.
Subject(s)
Mandibular Fractures/therapy , Adolescent , Adult , Aged , Child , Female , Humans , Male , Mandible/surgery , Mandibular Fractures/surgery , Middle Aged , Postoperative ComplicationsABSTRACT
Fractures of the orbital floor are frequently accompanied by diplopia. There are other bony injuries that may produce similar symptoms; however, these are rare. We will describe a case in which a fracture of the roof of the orbit, essentially involving the anterior cranial fossa, produced entrapment with diplopia. A six-month follow-up demonstrated excellent surgical and functional results.
