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Oral manifestations of systemic disease
Otolaryngology Head and Neck Surgery Volume 112 Number5
COURSE 1626-1 One-period course ($20)
Instruction Courses-- Sunday P43
Room NOCC-88 1:45-2:45
Streptomycin Perfusion of the Labyrinth Through the Round Window JOHN J. SHEA,JR., MD, and XIANXI GE, MD Memphis, Tenn.
Educational objectives: To understand Meniere's disease and to perform streptomycin perfusion of the labyrinth through the round window.
In patients with unilateral stage 1I and III Meniere's disease, the treatment of choice is to perfuse the labyrinth through the round window with streptomycin dissolved in hyaluronan. The Shea Classification of Meniere's disease into five stages will be explained, together with the details of making the diagnosis in each stage, especially in those patients with unilateral Meniere's disease in stages II and III suitable for streptomycin perfusion. Anesthesia of the drum with EMLA, the incision, and opening of the round window niche when necessary, and the injection of 12 mg/ml of streptomycin dissolved in hyaluronan are explained in detail. One gram of streptomycin is given intravenously during 4 hours while the patient remains with the operated ear up on a pillow. The management of the patient after operation, especially the vestibular rehabilitation necessary for the patient to accommodate to the loss of the vestibular receptors in the operated ear, will be explained. Approximately 90% of patients have complete relief from dizzy spells, with reduction in the fullness and low-frequency tinnitus, with no more than 5% with any further hearing loss. We will also explain how to do dexamethasone perfusion for patients in stage I Meniere's disease without hearing loss, and Marcaine perfusion with intravenous xylocaine in patients with severe unilateral tinnitus. A VHS tape of the course will be distributed to all who attend.
COURSE 1627-I One-period course ($20)
of each group will be discussed. The anatomic variants found within the oral cavity must also be understood, because they may be confused with pathologic changes. Slides of over 100 representative cases will be presented.
COURSE ! 629-3 Three-period course ($60)
Room NOCC-91-92 1:45-5:15
Practice Management--lmprove Patient Care and Reduce Overhead K.J. LEE,MD New Haven, Conn,
Educational objectives: To take better care of patients and to reduce overhead and be more cost-effective.
The success of a medical practice must be measured not by the "bottom line" but by the excellence of patient care. Yet, excellent patient care stands or falls on the infrastructure of business management and the delivery of patient services. Business management, the delivery of patient services, and the understanding of the daily barrage of legalities, however, is an area in which most physicians lack expertise; they have to pick it up as they are developing their practice. They pay a high price in wasted energy, wasted time, business management mistakes, and lost revenue. This 3-hour workshop will enable physicians and administrators to cut down on the "high price" of establishing an effective infrastructure for their medical practices. Time is alloted for formation of organizational structure and office policies, compensation, training, dismissal, cost-effective accounting, medical and business auditing, public relations, internal and external marketing, "managing "managed care,'" the logistics of branch offices, space allocation, and vertical and horizontal integrations. In this climate, physicians often find themselves in positions that require them to negotiate with administrators, business executives, attorneys, and medical directors. Time will be allocated for a session in negotiation.
Room NOCC-89 1:45-2:45
Oral Manifestations of Systemic Disease WILLIAM LAWSON,MD, DDS New York, N.Y.
Educational objectives: To recognize lesions o f the oral cavity and to order appropriate diagnostic tests and select therapy.
Systemic disease within the oral cavity may selectively involve the dental structures, gingiva, oral mucosa, or alveolus. Etiologic agents include genetic, metabolic, inflammatory, infectious, and neoplastic disorders. Despite the diverse causes of oral pathology, the clinical manifestations are limited to keratotic, pigmented, erosive, hypertrophic, and destructive lesions. The differential diagnosis
COURSE 1630-2 Two-period course ($40)
Room NOCC-93 1:45-4:00
Pediatric Cochlear Implant: Surgical and Rehabilitative Issues SIMON C. PARISIER,MD, PATRICIAM, CHUTE,MD, and MARY ELLEN NEVINS, EdD New York, N.Y.
Educational objectives: To select appropriate children f o r implantation and to counsel and recommend to parents considering cochlear implants the aspects of surgery, postoperative habilitation, and tuning.
This instructional course will be presented by the cochlear implant team at Manhattan Eye, Ear & Throat Hos-
COURSE 1626-1 One-period course ($20)
Instruction Courses-- Sunday P43
Room NOCC-88 1:45-2:45
Streptomycin Perfusion of the Labyrinth Through the Round Window JOHN J. SHEA,JR., MD, and XIANXI GE, MD Memphis, Tenn.
Educational objectives: To understand Meniere's disease and to perform streptomycin perfusion of the labyrinth through the round window.
In patients with unilateral stage 1I and III Meniere's disease, the treatment of choice is to perfuse the labyrinth through the round window with streptomycin dissolved in hyaluronan. The Shea Classification of Meniere's disease into five stages will be explained, together with the details of making the diagnosis in each stage, especially in those patients with unilateral Meniere's disease in stages II and III suitable for streptomycin perfusion. Anesthesia of the drum with EMLA, the incision, and opening of the round window niche when necessary, and the injection of 12 mg/ml of streptomycin dissolved in hyaluronan are explained in detail. One gram of streptomycin is given intravenously during 4 hours while the patient remains with the operated ear up on a pillow. The management of the patient after operation, especially the vestibular rehabilitation necessary for the patient to accommodate to the loss of the vestibular receptors in the operated ear, will be explained. Approximately 90% of patients have complete relief from dizzy spells, with reduction in the fullness and low-frequency tinnitus, with no more than 5% with any further hearing loss. We will also explain how to do dexamethasone perfusion for patients in stage I Meniere's disease without hearing loss, and Marcaine perfusion with intravenous xylocaine in patients with severe unilateral tinnitus. A VHS tape of the course will be distributed to all who attend.
COURSE 1627-I One-period course ($20)
of each group will be discussed. The anatomic variants found within the oral cavity must also be understood, because they may be confused with pathologic changes. Slides of over 100 representative cases will be presented.
COURSE ! 629-3 Three-period course ($60)
Room NOCC-91-92 1:45-5:15
Practice Management--lmprove Patient Care and Reduce Overhead K.J. LEE,MD New Haven, Conn,
Educational objectives: To take better care of patients and to reduce overhead and be more cost-effective.
The success of a medical practice must be measured not by the "bottom line" but by the excellence of patient care. Yet, excellent patient care stands or falls on the infrastructure of business management and the delivery of patient services. Business management, the delivery of patient services, and the understanding of the daily barrage of legalities, however, is an area in which most physicians lack expertise; they have to pick it up as they are developing their practice. They pay a high price in wasted energy, wasted time, business management mistakes, and lost revenue. This 3-hour workshop will enable physicians and administrators to cut down on the "high price" of establishing an effective infrastructure for their medical practices. Time is alloted for formation of organizational structure and office policies, compensation, training, dismissal, cost-effective accounting, medical and business auditing, public relations, internal and external marketing, "managing "managed care,'" the logistics of branch offices, space allocation, and vertical and horizontal integrations. In this climate, physicians often find themselves in positions that require them to negotiate with administrators, business executives, attorneys, and medical directors. Time will be allocated for a session in negotiation.
Room NOCC-89 1:45-2:45
Oral Manifestations of Systemic Disease WILLIAM LAWSON,MD, DDS New York, N.Y.
Educational objectives: To recognize lesions o f the oral cavity and to order appropriate diagnostic tests and select therapy.
Systemic disease within the oral cavity may selectively involve the dental structures, gingiva, oral mucosa, or alveolus. Etiologic agents include genetic, metabolic, inflammatory, infectious, and neoplastic disorders. Despite the diverse causes of oral pathology, the clinical manifestations are limited to keratotic, pigmented, erosive, hypertrophic, and destructive lesions. The differential diagnosis
COURSE 1630-2 Two-period course ($40)
Room NOCC-93 1:45-4:00
Pediatric Cochlear Implant: Surgical and Rehabilitative Issues SIMON C. PARISIER,MD, PATRICIAM, CHUTE,MD, and MARY ELLEN NEVINS, EdD New York, N.Y.
Educational objectives: To select appropriate children f o r implantation and to counsel and recommend to parents considering cochlear implants the aspects of surgery, postoperative habilitation, and tuning.
This instructional course will be presented by the cochlear implant team at Manhattan Eye, Ear & Throat Hos-