The Experts below are selected from a list of 240 Experts worldwide ranked by ideXlab platform
Michael H. Zaroukian - One of the best experts on this subject based on the ideXlab platform.
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Coughing and Central Venous Catheter Dislodgement
2016Co-Authors: William R Jacobs, Michael H. Zaroukian, M. D., Ph. DAbstract:ABSTRACT. Silastic central venous catheters are subject to dislodgement from a variety of causes. Only one occurrence of catheter dislodgement has been previously reported in connec-tion with coughing. We report four additional cases of Silastic central venous catheter dislodgement associated with forceful coughing paroxysms, alone or in combination with emesis or rectal tenesmus. Three episodes of catheter dislodgement oc-curred in adolescents or young adults with cystic fibrosis, who may constitute a particularly high-risk group. Dislodgement in two patients was asymptomatic. These cases suggest that pa-tients with frequent or severe paroxysms of increased intratho-racic pressure may be at higher risk of catheter dislodgement. Since dislodgement may be initially asymptomatic and can cause serious complications, a high index of suspicion for dislodgement in patients with Silastic central venous catheters and coughing paroxysms is advised. (Journal of Parenteral and Enteral Nutrition 15:491-493, 1991) Silastic central venous catheters are commonly used to provide long-term venous access. Both fully implanted injection port (eg, Port-a-Cath, Pharmacia-Deltec, St. Paul, MN) and cuffed external catheters (eg, Hickman, Quinton Instrument Co., Seattle, WA) are used widely. Several immediate and delayed complications have been described.’- ’ Catheter dislodgement has been reported in association with vigorous upper extremity movements,4 ° 5 or without obvious precipitating factors.2°6-g Computer-assisted searching of the MEDLINE data bases (1966-1990) revealed only one report of central venous catheter dislodgement associated with coughing. ’ We report four additional cases of Silastic central venous catheter dis-lodgement which were associated with paroxysmal in-creases in intrathoracic pressure due to coughing, with or without emesis or rectal tenesmus. CASE REPORTS Each case described involved placement of a Silastic central venous catheter via a subclavian approach with radiographic confirmation of catheter tip placement in the superior vena cava
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Coughing and central venous catheter dislodgement.
Journal of Parenteral and Enteral Nutrition, 1991Co-Authors: William R Jacobs, Michael H. ZaroukianAbstract:Silastic central venous catheters are subject to dislodgement from a variety of causes. Only one occurrence of catheter dislodgement has been previously reported in connection with coughing. We report four additional cases of Silastic central venous catheter dislodgement associated with forceful coughing paroxysms, alone or in combination with emesis or rectal tenesmus. Three episodes of catheter dislodgement occurred in adolescents or young adults with cystic fibrosis, who may constitute a particularly high-risk group. Dislodgement in two patients was asymptomatic. These cases suggest that patients with frequent or severe paroxysms of increased intrathoracic pressure may be at higher risk of catheter dislodgement. Since dislodgement may be initially asymptomatic and can cause serious complications, a high index of suspicion for dislodgement in patients with Silastic central venous catheters and coughing paroxysms is advised. (Journal of Parenteral and Enteral Nutrition 15:491-493, 1991)
Robert H Ossoff - One of the best experts on this subject based on the ideXlab platform.
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phonosurgery Silastic medialization for unilateral vocal fold paralysis
Operative Techniques in Otolaryngology-head and Neck Surgery, 1993Co-Authors: John R Wanamaker, James L Netterville, Robert H OssoffAbstract:Since its reintroduction by Isshiki et all in the 1970s, laryngeal framework surgery has gained increasing p0f.ularity as a means of managing vocal cord paralysis. ·7 Although for many years Teflon injection has been the mainstay in treatment.v" this technique suffers from several potential drawbacks. It is difficult to determine the precise depth and proper amount of Teflon to inject, and once injected it is essentially permanent.5,9,10 The problem with this permanence is that Teflon can migrate, form granulomas, and interfere with the vibratory characteristics of the vocal fold (mucosal wave). For these reasons, Silastic medialization is an attractive alternative to teflon for the management of the weak, breathy voice, ineffective cough, and aspiration associated with unilateral vocal fold paralysis. This article details our 5-year experience with primary (1°) Silastic medialization (performed under general anesthesia at the time of lower cranial nerve injury or sacrifice) and secondary (2°) Silastic medialization (performed under local anesthesia for a pre-existent vocal fold dysfunction)
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Silastic medialization and arytenoid adduction the vanderbilt experience a review of 116 phonosurgical procedures
Annals of Otology Rhinology and Laryngology, 1993Co-Authors: James L Netterville, R E Stone, Francisco J Civantos, Elizabeth S Luken, Robert H OssoffAbstract:From April 1987 to April 1992, 116 phonosurgical procedures were performed to treat glottal incompetence. The initial numbers of these surgical procedures included the following: 29 primary Silastic medializations, 3 primary Silastic medializations with arytenoid adduction, 53 secondary Silastic medializations, 4 secondary Silastic medializations with arytenoid adduction, and 11 bilateral Silastic medializations. These procedures are useful in treating unilateral true vocal cord paralysis, scarring, bowing, or paresis, as well as bilateral true vocal cord bowing. Of the initial 100 patients, 16 later underwent a revision with either a larger implant's being placed or an arytenoid adduction. Primary Silastic medialization is the placement of an implant under general anesthesia in the same surgical setting in which laryngeal innervation is sacrificed. Secondary Silastic medialization is the placement of an implant under local anesthesia for a preexistent vocal cord malfunction. In either case, overall voice...
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Silastic medialization and arytenoid adduction the vanderbilt experience a review of 116 phonosurgical procedures
Annals of Otology Rhinology and Laryngology, 1993Co-Authors: James L Netterville, R E Stone, Francisco J Civantos, Elizabeth S Luken, Robert H OssoffAbstract:From April 1987 to April 1992, 116 phonosurgical procedures were performed to treat glottal incompetence. The initial numbers of these surgical procedures included the following: 29 primary Silastic medializations, 3 primary Silastic medializations with arytenoid adduction, 53 secondary Silastic medializations, 4 secondary Silastic medializations with arytenoid adduction, and 11 bilateral Silastic medializations. These procedures are useful in treating unilateral true vocal cord paralysis, scarring, bowing, or paresis, as well as bilateral true vocal cord bowing. Of the initial 100 patients, 16 later underwent a revision with either a larger implant's being placed or an arytenoid adduction. Primary Silastic medialization is the placement of an implant under general anesthesia in the same surgical setting in which laryngeal innervation is sacrificed. Secondary Silastic medialization is the placement of an implant under local anesthesia for a preexistent vocal cord malfunction. In either case, overall voice results for unilateral paralysis are very good. Primary Silastic medialization significantly decreases the postoperative rehabilitation period in skull base patients because of the immediate postoperative glottal competence and decreased use of perioperative tracheotomy. Bilateral implants yielded good results in 6 patients with presbylaryngis, but 6 other patients with bowing from other causes experienced only moderate improvement in speech quality. There were no implant extrusions; however, 1 implant was removed secondary to a persistent laryngocutaneous fistula in a patient who had previously undergone laryngeal irradiation. This was the only complication in this series.
William R Jacobs - One of the best experts on this subject based on the ideXlab platform.
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Coughing and Central Venous Catheter Dislodgement
2016Co-Authors: William R Jacobs, Michael H. Zaroukian, M. D., Ph. DAbstract:ABSTRACT. Silastic central venous catheters are subject to dislodgement from a variety of causes. Only one occurrence of catheter dislodgement has been previously reported in connec-tion with coughing. We report four additional cases of Silastic central venous catheter dislodgement associated with forceful coughing paroxysms, alone or in combination with emesis or rectal tenesmus. Three episodes of catheter dislodgement oc-curred in adolescents or young adults with cystic fibrosis, who may constitute a particularly high-risk group. Dislodgement in two patients was asymptomatic. These cases suggest that pa-tients with frequent or severe paroxysms of increased intratho-racic pressure may be at higher risk of catheter dislodgement. Since dislodgement may be initially asymptomatic and can cause serious complications, a high index of suspicion for dislodgement in patients with Silastic central venous catheters and coughing paroxysms is advised. (Journal of Parenteral and Enteral Nutrition 15:491-493, 1991) Silastic central venous catheters are commonly used to provide long-term venous access. Both fully implanted injection port (eg, Port-a-Cath, Pharmacia-Deltec, St. Paul, MN) and cuffed external catheters (eg, Hickman, Quinton Instrument Co., Seattle, WA) are used widely. Several immediate and delayed complications have been described.’- ’ Catheter dislodgement has been reported in association with vigorous upper extremity movements,4 ° 5 or without obvious precipitating factors.2°6-g Computer-assisted searching of the MEDLINE data bases (1966-1990) revealed only one report of central venous catheter dislodgement associated with coughing. ’ We report four additional cases of Silastic central venous catheter dis-lodgement which were associated with paroxysmal in-creases in intrathoracic pressure due to coughing, with or without emesis or rectal tenesmus. CASE REPORTS Each case described involved placement of a Silastic central venous catheter via a subclavian approach with radiographic confirmation of catheter tip placement in the superior vena cava
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Coughing and central venous catheter dislodgement.
Journal of Parenteral and Enteral Nutrition, 1991Co-Authors: William R Jacobs, Michael H. ZaroukianAbstract:Silastic central venous catheters are subject to dislodgement from a variety of causes. Only one occurrence of catheter dislodgement has been previously reported in connection with coughing. We report four additional cases of Silastic central venous catheter dislodgement associated with forceful coughing paroxysms, alone or in combination with emesis or rectal tenesmus. Three episodes of catheter dislodgement occurred in adolescents or young adults with cystic fibrosis, who may constitute a particularly high-risk group. Dislodgement in two patients was asymptomatic. These cases suggest that patients with frequent or severe paroxysms of increased intrathoracic pressure may be at higher risk of catheter dislodgement. Since dislodgement may be initially asymptomatic and can cause serious complications, a high index of suspicion for dislodgement in patients with Silastic central venous catheters and coughing paroxysms is advised. (Journal of Parenteral and Enteral Nutrition 15:491-493, 1991)
Ingeborg M. Watzke - One of the best experts on this subject based on the ideXlab platform.
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Autogenous auricular cartilage graft for temporomandibular joint repair. A comparison of technique with and without temporary Silastic implantation.
Journal of Cranio-Maxillofacial Surgery, 1991Co-Authors: Myron R Tucker, Ingeborg M. WatzkeAbstract:Four Macaca fascicularis monkeys underwent bilateral temporomandibular joint surgery including disc removal, condyle recontouring and disc replacement using autogenous auricular cartilage grafts. One side was treated with the cartilage graft alone while the other side was treated with a cartilage graft combined with a temporarily implanted 0.02 inch dacron-reinforced Silastic sheet. The Silastic sheeting was removed at twelve weeks after the initial surgery. The monkeys were sacrificed at fourteen, twenty-four, thirty-six and fifty-two weeks after the initial disc removal and cartilage grafting. The joints treated with cartilage grafts alone showed significant fibrous connective tissue adhesions which had formed between the inferior surface of the graft and the articulating surface of the condyle. In the joints treated with a cartilage graft and Silastic sheeting a joint space was clearly maintained between the cartilage graft and condylar surface without the formation of fibrous connective tissue adhesions. It appears that temporary implantation of a thin Silastic sheet combined with autogenous cartilage grafting may prevent the formation of fibrous connective tissue adhesions within the joint.
William F. Blair - One of the best experts on this subject based on the ideXlab platform.
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Ulnar Nerve Compression after Silastic Ulnar Head Replacement.
The Iowa orthopaedic journal, 1991Co-Authors: Tarek Abdalla El-gammal, William F. BlairAbstract:Abstract A patient with Silastic radiocarpal and ulnar head replacement arthroplasty presented six years after the operation with symptoms of ulnar neuropathy. Bone resorption of the distal ulna resulted in volar subluxation of the ulnar head implant which compressed the ulnar nerve at its entrance into Guyon's canal. Removal of the implant and decompression of the nerve resulted in recovery of ulnar nerve funcions. Compression neuropathy of the ulnar nerve should be considered a potential complication of the use of Silastic ulnar head replacements.
