Voice restoration after total laryngectomy with tracheoesophageal puncture and voice prosthesis.

Removal of the voice box or larynx is the usual treatment for advanced cancer of the larynx. Tracheoesophageal puncture (TEP) has become an accepted method for voice restoration following total laryngectomy. Eleven patients under went total laryngectomy with TEP at San Pablo Hospital Medical Center between March 1989 and October 1995.

Efficacy of ceftibuten for pediatric patients undergoing adenotonsillectomy.

A survey between Otolaryngologist Head and Neck Surgeons in Puerto Rico and a prospective study was done, to evaluate the efficacy of ceftibuten in pediatric patients undergoing adenotonsillectomy. Surgery of the tonsils and adenoids is the most common operation performed in the pediatric age by the Otolaryngologist Head and Neck Surgeons in Puerto Rico. Over 70% are performed in a ambulatory setting and almost all of the patients are given antibiotics after surgery.

Differences in membrane ion transport between hepatocytes from the periportal and the pericentral areas of the liver lobule.

We studied the Na+/K+ pump, Na+/K+ ATPase activity, and oxygen consumption (QO2) in hepatocytes isolated from the periportal (PH) and pericentral (CH) regions of the liver lobule, to provide an insight into the functional properties of these cells. Na+/K+ pump activity was determined using 86Rb+ (a functional analog of K+) and ouabain, a specific inhibitor of this transport system. Our results indicate the the Na+/K+ pump and Na+/K+ ATPase activity are significantly lower in CH than in PH, although basal ouabain-sensitive (OS) QO2 was negligible in both of these cell preparations.

Changing trends in adenotonsillectomy at San Pablo Hospital 1983 vs. 1993.

The purpose of this paper is to review the changing trends in Adenotonsillectomies performed in San Pablo Medical Center during the last ten years. We have reviewed using a 25 variable questionnaire all patients undergoing this surgical procedure during the first six months in 1983 and compared the information with the patients having this procedure during the first six months of 1993. We conclude that the number of interventions, the indications, prior medical history and cost effects have changed substantially.

Metastatic melanoma to the facial nerve.

Isolated metastatic malignant melanoma to the facial nerve has never been reported. This presentation illustrates a primary melanoma of the helix of the ear that was treated by excisional biopsy and then wedge resection in 1983. The primary melanoma was Clark's level IV and 1.

Foreign bodies of the esophagus the San Pablo Hospital experience.

Between 1978 and 1990, a total of 76 cases of esophageal foreign bodies were taken to the operating suite at San Pablo Hospital. Of the 76 patients, 26 were in the pediatric age group, and 56 adults. Dysphagia and foreign body sensation were the predominant complaint.

Overview of results with tracheoesophageal puncture after total laryngectomy.

Ten years have passed since the introduction of the tracheoesophageal puncture. The voice restoration field has dramatically changed upon the introduction of this new technique. This permits the patients to speak as early as ten days after surgery.

Tracheoesophageal puncture for voice restoration after extended laryngopharyngectomy.

Tracheoesophageal puncture was performed in ten of our patients undergoing extended laryngopharyngectomy. Three fistulas were allowed to close, and two patients were dissatisfied with their results, which allowed for an overall 50% success rate in this subgroup. The resultant voice was objectively compared with similar groups of patients undergoing primary and secondary tracheoesophageal puncture after standard laryngectomy.

Congenital cholesteatomas in children: an embryologic correlation.

The clinical findings in 37 children with congenital cholesteatoma of the middle ear, 17 of which have not been previously reported, are presented. Clinical findings and surgical observations are correlated with recent developmental studies. It is hypothesized that congenital cholesteatoma may originate from an epidermoid formation, which has been identified in the anterior superior lateral tympanic cavity adjacent to the anterior annulus during fetal development, and which normally is present early in development, involuting by 33 weeks' gestation.

Muscle capillarity in rats with increased blood oxygen affinity.

To investigate the effects of low P50Hb on muscle capillarity, rats were injected with Na-cyanate (50 mg/kg BW) every day for 2 or 4 weeks (experimental). Controls received injections of saline. After 2 weeks P50 was reduced in the experimental animals (20.

Cholesteatoma in the pediatric age group.

The diagnosis and management of cholesteatoma in children remains controversial. In the past 15 years, the senior author (S.C.

Primary tracheoesophageal puncture for voice restoration.

A 93 percent success rate of voice restoration after primary tracheoesophageal puncture was achieved in 15 patients. Patients were usually able to talk within 3 weeks after laryngectomy. Male patients without chronic obstructive lung disease achieved better results.

A review of twenty congenital cholesteatomas of the middle ear in children.

Cholesteatomas, arising within the middle ear space behind an intact tympanic membrane, have been detected more frequently in recent years. This article reviews 19 children (with a mean age of 4.3 years) who underwent surgery over a 7-year period for removal of cholesteatomas from behind intact tympanic membranes.