Pleurocutaneous fistula as a complication of oleothorax. CT findings in three patients.

The purpose of this study was to highlight pleurocutaneous fistula, documented on computed tomography (CT) scans, as a complication of oleothorax. CT images of the chest were evaluated retrospectively in three patients with pleurocutaneous fistula complicating oleothorax. The images documented oleothorax rupture in all three, with only one patient (case 2) showing concomitant surrounding chest wall and axillary inflammatory reaction. Surgery performed on one patient (case 1) confirmed the CT findings. While CT is invaluable in the demonstration of complications of oleothorax, to our knowledge CT depiction of oleothorax has not been reported in the literature. This complication may be more common than described in earlier literature, with the advent of cross-sectional imaging. In the right clinical setting, CT findings of inflammation or edema surrounding the oleothorax rupture may warrant surgical intervention.

In-111 CYT-103 immunoscintigraphy in the imaging of ovarian carcinoma.

Fifteen presurgical patients with a history of ovarian carcinoma were evaluated with immunoscintigraphy using the In-111-labeled monoclonal antibody conjugate CYT-103. Twelve of these patients had residual neoplasia at time of laparotomy. A single intravenous dose of the radiolabeled monoclonal antibody was given to these patients before restaging laparotomy. All patients also underwent CT scanning of the abdomen and pelvis before laparotomy. Immunoscintigraphy detected the presence of disease in 10 of 12 patients before surgery, whereas CT scanning detected disease in only 6 of these 12 women. The results of this study indicate that immunoscintigraphy using In-111 CYT-103 is more sensitive than CT and may add useful information to the preoperative evaluation of women with ovarian carcinoma.

Airway management in craniofacial surgery: experience in 542 patients.

Five hundred and forty-two patients undergoing 579 craniofacial surgical procedures were admitted to the Intensive Care Unit of the Hospital for Sick Children, Toronto, during the 13-year period of 1972 to 1984. Ninety-eight of these patients underwent tracheotomies; 12 significant complications were documented. Two hundred and seventy-eight patients were managed with nasal endotracheal intubation for greater than 24 hours postoperatively; 42 related complications were documented. Good communication among the craniofacial surgeon, otolaryngologist, anesthetist and intensivist is crucial for the safe management of the various airway problems observed in patients with major craniofacial anomalies undergoing corrective surgery.

Metastatic renal carcinoma to larynx.

The larynx is a most unusual site for metastatic cancer. A case of metastatic renal cell carcinoma of the larynx is presented to illustrate the following features: its exceptional indolent course; the difficulty in arriving at a correct diagnosis, and the good result following local excision.

Bulimia and parotid enlargement--case report and treatment.

Bulimia is a behavioral eating disorder affecting young adult women. Parotid enlargement may occur as a result, although the cause of this swelling is as yet unknown. These changes can be irreversible, unresponsive to resumption of normal dietary habits. The physical unattractiveness of this complication can adversely affect the patient's wellbeing, demanding more active treatment. Treatment of this parotid enlargement has not previously been dealt with definitively. A case study is presented wherein such an individual was treated with bilateral superficial parotidectomy with good results, both emotionally and physically. As the incidence of this disorder continues to increase dramatically, the surgeon may gain a place in the treatment of bulimia.