Emmanuel S. Helidonis

Laser shaping of composite cartilage grafts

INTRODUCTION The restoration of malformations of different etiology in the head and neck area continue to be a problem to the reconstructive surgeon. Many of these problems are created by the destruction of cartilage. The success of the reconstructive effort very often depends on the selection of a composite cartilage graft of proper size, shape, and thickness, which has to replace the missing cartilage. Despite the best of surgeons intentions, the postoperative result is not always satisfactory due to the difficulty in obtaining a cartilage of the proper shape. Using a carbon dioxide laser, composite cartilage samples 0.4 to 1 mm thick taken from rabbits ears were irradiated. METHODS Rabbit ear cartilage with covering epithelium was used. The thickness of the composite graft measured 0.4 to 1 mm. Specimens were reshaped, treated with a carbon dioxide laser, then immersed in saline. CONCLUSION It was observed that it was possible to change the shape of the cartilage, which then had the tendency to retain its new form for several days. Thicker composite grafts retained the new shape more satisfactorily. The significance of this experiment for future corrective surgery in various parts of the head and neck area is evident. We anticipate that this technique may be useful to mold grafted cartilage for use in complex reconstructions such as nasal, auricular, and tracheal deformities.

Bronchoscopy for foreign body removal in children. A review and analysis of 210 cases

OBJECTIVE A foreign body aspiration in the tracheobronchial tree is a dangerous and common medical emergency in childhood, with serious and potentially lethal consequences. It must be suspected in children with a suggestive history, even though the clinical symptoms or radiographic findings are not pathognomonic for foreign body aspiration. METHODS In this study 210 pediatric cases, with a suggestive history of foreign body aspiration undergoing bronchoscopy in the last 8 years in the department, were reviewed. In all cases bronchoscopy was performed under general anesthesia using a Storz ventilation bronchoscope with distal cold light illumination. RESULTS In 130 patients a foreign body was discovered, in 17 cases pus was aspirated and in 63 cases there were no findings. Seventy-eight (60%) foreign bodies were found in the right main bronchus, 43 (33.1%) in left main bronchus, seven (5.4%) in both bronchi and two (1.5%) were found in the subglottic area. The incidence of bronchoscopy during the last 8 years was 28 procedures per 100000 children population per year in the island of Crete. CONCLUSION More attention should be given to the need for a careful history and the use of radiographs as supplemental information to make the decision to perform a bronchoscopy. The parents, also, should pay attention not to allow children dry fruits and small toys, as well as, teaching their children to avoid any physical or emotional activity while having a full mouth.

Benign paroxysmal positional vertigo: 10-year experience in treating 592 patients with canalith repositioning procedure.

Objective: To assess the long‐term efficacy of canalith repositioning procedure (CRP) in the treatment of patients with benign paroxysmal positional vertigo (BPPV).

In vivo detection and staging of epithelial dysplasias and malignancies based on the quantitative assessment of acetic acid–tissue interaction kinetics

A novel approach to the problem of non-destructive detection and staging of tissue lesions is presented. The method relies on the in vivo quantitative assessment of the spatial and temporal alterations of light-scattering properties, induced in epithelial dysplasias and malignancies of the cervix and larynx, after topical application of acetic acid solution. Initial clinical trials show that the method is capable of detecting incipient lesions and that differences in the dysplasia and malignancy grade are clearly manifested in the measured temporal characteristics of the phenomenon.

Ectopic thyroid gland in the submandibular region

A rare case of an ectopic thyroid gland appearing as a submandibular mass in a 30-year-old female patient is presented. Special emphasis is placed on the origin, unusual location, functioning status, pathology and diagnostic problems created by this interesting case.

Laser shaping of cartilage

The carbon dioxide laser has been used for the first time to change the cartilages shape. After the laser irradiation the cartilage has the tendency to retain its new form. Different types of laser modified cartilage structures were studied. The inferred physical mechanism for cartilage shaping using the stresses relaxation process is presented. The clinical significance of the results for corrective laser surgery is discussed.

The Use of the Ligasure Vessel Sealing System in Parotid Gland Surgery

OBJECTIVE: To evaluate the role of the Ligasure™ Vessel Sealing System (LVSS; Valleylab, Boulder, CO) in parotid surgery. STUDY DESIGN: A prospective study was conducted on 12 consecutive patients undergoing superficial parotidectomy, performed by using the LVSS device as the primary means of ligation. Inclusion criteria included parotid mass with no preoperative suspicion of malignancy, and no extension to the deep lobe of the parotid gland. Efficacy of hemostasis, cut-closure time, and postoperative complications were assessed. Results were compared with a historical control group, including cases on which the LVSS was not available. RESULTS: LVSS proved effective in providing ligation and hemostasis. There was a mean time gain of 52 minutes, compared with our historical control group. No postoperative bleeding, seroma, salivary fistula, or Frey syndrome were observed. One case of transient facial weakness occurred, which was completely resolved within 6 months. CONCLUSION: LVSS is a safe device for parotid gland surgery, providing sufficient hemostasis and reducing operative time.

Ligasure versus Cold Knife Tonsillectomy

Objective: To assess parameters related to ligasure tonsillectomy (LT) versus cold knife tonsillectomy (CKT) procedure.

FAMILIAL BILATERAL ACINIC CELL CARCINOMA OF THE PAROTID SYNCHRONOUS WITH PITUITARY ADENOMA: CASE REPORT

Acinic cell carcinoma is a common neoplasm of the salivary glands that occurs predominately in the parotid. Only one case of a familial recurrence of such a neoplasm and 16 cases of bilateral tumors have been reported.

The silent epidural abscess as a complication of acute otitis media in children

Acute otitis media with complications is a persistent problem in the modern antibiotic era with a relatively high mortality rate. Acute mastoiditis is a serious complication of acute otitis media with potentially grave consequences and the epidural abscess constitutes the commonest of all intracranial complications, arising from middle ear infections. We report two cases of children with acute mastoiditis without evidence of intracranial complication or subperiosteal abscess, in whom the early evaluation with computed tomography (CT) disclosed an unsuspected epidural abscess. Therefore, we stress the use of CT as a rule of thumb for every child with acute mastoiditis.