Congenital mid-line cervical cleft.

The mid-line cervical cleft is part of a broad spectrum of congenital mid-line branchiogenic syndromes. Two recent cases of this rare anomaly are presented, along with the clinical presentation, gross pathology and histopathology. The preferred operative technique of complete excision of the cervical cleft with Z-plasty is demonstrated.

Antibody-targeted photolysis. Bacteriocidal effects of Sn (IV) chlorin e6-dextran-monoclonal antibody conjugates.

Antibody-targeted photolysis is a technique for damaging or killing cells using light and an antibody-bound photosensitizer. In the present study, immunoconjugates were constructed to selectively kill Pseudomonas aeruginosa bacteria using tin (IV) chlorin e6 which was linked to dextran and then bound to the carbohydrate moiety of a monoclonal antibody specific for Pseudomonas aeruginosa Fisher type I polysaccharide antigen. Killing of Pseudomonas during mid-log phase growth was shown to be dependent upon light dose with complete bacterial cell killing observed at an irradiation dose of 80 J/cm2.

Pharyngeal cleft sinuses and cysts, and other benign neck lesions.

Few pediatricians can expect to acquire great personal experience in dealing with many of the aforementioned lesions. Nevertheless, an appreciation of the usual presentation and natural history of most of the entities will usually permit an accurate diagnosis and guide to management in all but the most obscure conditions.

Melanotic neuroectodermal tumor of infancy: report of two cases.

Melanotic neuroectodermal tumor of childhood is a rare lesion, but its presentation appears to be quite characteristic and a clinical diagnosis may be made with some confidence. Although this is an extremely rapidly growing, aggressive tumor, local excision appears to be adequate for cure.

Inhalation of a safety pin by a laryngectomized patient: a case report.

Otolaryngologists are well aware of the potentially devastating consequences of inhaling a sharp foreign body. We report here a case of a laryngectomized patient who accidentally inhaled a safety pin through his tracheal stoma under highly unusual circumstances. This proved to be a life-threatening situation which resolved only after a complicated hospital admission culminating in a thoracotomy.

The parathyroid adenoma: an imaging/surgical perspective.

The clinical picture of hyperparathyroidism has changed since the implementation of routine serum calcium testing, resulting in more asymptomatic patients undergoing early surgical exploration. Although operative complications (e.g.

Clinical diagnosis of neck lumps: a practical guide.

The clinical presentation of a neck mass in a child is obviously not always pathognomonic but a careful clinical appraisal can certainly limit the diagnostic options and reduce the need for complex and sometimes invasive investigations.

Acquired bronchial injury in neonates.

The increasing success of modern neonatology has been associated with the use of prolonged intubation, ventilation and respiratory support. Inappropriate management of the endotrachial tubes or excessive and improper use of suction catheters may result in significant tracheobronchial injury. These injuries range from readily reversible abrasions through to obstructing granulomas, polyps and even bronchial stenosis and acquired bronchial atresia.

An approach to stridor in infants and children.

Stridor is a clinical sign, common to many disease entities which may compromise the airway. Although stridor may herald a life-threatening condition, most patients have a minor self-limiting condition. Diagnosis based on the character of the stridor alone is tenuous, and consideration of presentation other than the stridor is discussed in the management of these infants.

Tracheotomy revision in infants: to facilitate extubation and restore phonation.

The formation of tracheal 'granuloma' in the tracheostomized infant, as a cause of aphonia and an obstacle to decannulation has long been recognized. Endobronchial or transtomal removal has been recommended; however, a number of these lesions were resected in conjunction with complete tracheostomy revision and found to be very much larger than suspected endoscopically and consisting of dense mature scar tissue. It is, therefore, suggested that resection of these lesions endoscopically or transtomally may be quite inadequate and an open procedure preferred.

Traumatic bronchial injuries in children.

Between 1975 and 1981 five children (three girls and two boys) from 3 to 11 years were treated for blunt chest trauma with major tears in two areas of the right main bronchus. All were hit or run over by motor vehicles and were in acute respiratory distress. All suffered right pneumothoraces; three did not respond to a chest tube with suction.

Diagnosis and therapy of necrotizing tracheobronchitis in ventilated neonates.

From January 1983 to September 1984 our neonatal ICU (NICU) treated eight endotracheally intubated infants who had suspected airway obstruction characterized by hypercarbia dissonant with severity of lung disease and difficulty in ventilation with lack of chest movement, both on conventional intermittent mandatory ventilation and high-frequency oscillation. Bronchoscopic removal of necrotic tissue was possible in six infants, two of whom survived. Bronchoscopy showed desquamation of epithelial surfaces, leaving encrusted exudations considered to be characteristic of necrotizing tracheobronchitis (NTB).

The management of medical emergencies in otolaryngology.

We have tried to present the clinically relevant medical problems that otolaryngologists may face and to suggest management plans. Emergencies are divided by specific problems into general chemical, metabolic, and surgical categories. Space limitation allows only discussion of the most important problems but will hopefully stimulate interest in the remainder.

Tracheoplasty--a new operation for complete congenital tracheal stenosis.

This is a report of a case of complete congenital tracheal stenosis confirmed by tracheobronchogram. The stenosis also involved the origin of the right main bronchus. The membranous portion of the trachea was absent.

External application of an irrigating lens loop for extracapsular cataract extraction.

A modified irrigating lens loop applied externally to the eye may be used to express the nucleus in an extracapsular cataract extraction. No skill is required in subluxating the nucleus into the anterior chamber, as this maneuver is not necessary. The danger of posterior capsule rupture is diminished because no counter-pressure is applied and the lens loop is not placed in the eye.