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Biomedical subjects

A W Weaver

Publications and source records attributed to A W Weaver.

At least 19 recordsLinked to original sources
PubMed1984

Elective carotid resection for squamous cell carcinoma of the head and neck.

Patients with squamous cell carcinoma adherent to the carotid artery have a very poor prognosis, but some can be salvaged by aggressive surgical resection. Preoperative four vessel arteriography with intracranial views is mandatory to detect coexisting arteriosclerotic disease which may limit collateral perfusion of the ipsilateral cerebral hemisphere. Matas-type occlusive tests performed preoperatively are potentially dangerous and do not provide quantitative information that can be obtained intraoperatively by measuring internal carotid artery stump pressures. If the stump pressure is 50 mm Hg or greater, carotid reconstruction is unnecessary. A stump pressure of less than 50 mm Hg is an indication for reconstruction if the pharynx has not been entered during resection. If mucosal entry will be necessary and the stump pressure is less than 50 mm Hg, resection should not be carried out because of the increased risk of graft complications. Somatosensory evoked potentials predict cerebral tolerance to temporary interruption of flow but do not necessarily predict tolerance to permanent interruption of flow. Autogenous vein is the graft material of choice for reconstruction. In those patients not reconstructed, low-dose heparinization started before operation and continued for 10 days may lessen the likelihood of delayed stroke from embolization of a propagated thrombus in the carotid stump.

Adult↗
PubMed1983

Ototoxicity associated with cis-platinum in three chemotherapy multi-drug regimens.

Hearing threshold differences postcis-platinum, relative to precis-platinum levels, were studied in 21 men from a Veterans Administration Medical Center. These patients had previously untreated advanced epidermoid cancers of the head and neck. Each patient received one of three drug combinations: (1) cis-platinum, Oncovin, and bleomycin (n = 9); (2) cis-platinum and 5-fluorouracil (n = 7); or (3) cis-platinum and bleomycin (n = 5). Wide variations in prechemotherapy hearing thresholds prevented analysis among various drug combinations. Therefore, the three groups were pooled to compare the thresholds by frequency. The frequencies tested and analyzed were: 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, and 8000 Hz. Significant differences were found at 2000 Hz (P less than 0.01) and 8000 Hz (P less than 0.05). Any existing ototoxic effects of cis-platinum may have been overridden by already high prechemotherapy hearing thresholds at 4000 Hz. Since 2000 Hz was most sensitive to the ototoxic effects of cis-platinum it is suggested that this frequency be monitored routinely as a part of standard chemotherapy assessment.

Aged↗
PubMed1983

Evaluation of osteogenesis following immediate and delayed reimplantation of frozen autogenous mandibular bone.

A follow-up study of the feasibility of delayed reimplantation of frozen autogenous mandibles after ablative surgery for oral carcinomas with mandibular involvement was performed. Fifteen young adult mongrel dogs were used and evaluated clinically, bacteriologically, radiographically, histologically, and by radionuclide imaging. The animals were divided into two groups according to whether they underwent immediate or delayed reimplantation. These were subdivided into those who received grafts with and without autogenous marrow augmentation. The results were positive and suggested clinical evaluation. Twelve patients had undergone delayed reimplantation along with marrow augmentation over the past 3 years. Again, the results are most promising and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in the cancer patient.

Animals↗
PubMed1983

Feeding device for glossectomy patients.

Instructions are provided for making a feeding spoon from a plastic syringe for use by patients who have had a glossectomy. This adaptation may be accomplished using only a hacksaw blade and sandpaper. Such a device may be indicated for patients who have had at least 60% of their tongue resected, but who are not at significant risk of aspiration.

Eating↗
PubMed1982

Modified bilobular ("gemini") pectoralis major myocutaneous flap.

The bilobular or gemini type of pectoralis major myocutaneous flap evolved from a desire to simplify the closure of large surgical defects of both mucosa and skin that could not be satisfactorily closed primarily. Previously, such defects often required combined or multiple reconstructive procedures such as myocutaneous and deltopectoral flap operations. The mucosal and skin defects are closed by two skin paddles supported by a single muscular vascular pedicle. The skin paddles are fashioned side by side and separated from each other as the muscle is folded between them parallel to the vascular axis. All of the defects were successfully closed and the major portion of all grafts survived. This operation permits single-stage reconstruction after ablation of tumors or treatment of complications which produced large through-and-through mucocutaneous defects of the head and neck area.

Adult↗
PubMed1980

Combination of cis-platinum, oncovin, and bleomycin (COB) prior to surgery and/or radiotherapy in advanced untreated epidermoid cancer of the head and neck.

A prospective study was carried out to investigate the effectiveness and feasibility of two courses of combination therapy with COB every three weeks prior to surgery and/or radiotherapy in 70 patients with advanced untreated epidermoid cancer of the head and neck. Of 65 patients evaluable after two courses of chemotherapy, 16 had a complete remission (CR) and 36 had a partial remission (PR; > 50% -- < 100%) for a total major response rate of 80%. After completion of therapy with surgery and/or radiotherapy, 61% of the responders were still in CR with disease free survival ranging from four to 22 months (median eight plus months), while only 15% of non-responders were in CR. Drug toxicity was tolerable with no severe or life threatening side effects, and no added risks after surgery or radiotherapy were encountered. We concluded the effectiveness and feasibility of COB were established.

Bleomycin↗
PubMed1978

Partial laryngectomy: analysis of associated swallowing disorders.

Evaluation of postoperative swallowing ability in thirty-eight patients having had partial laryngectomy indicates that there are marked differences in the degree of dysphagia among individuals with similar surgical defects. This variation in swallowing disability, however, appears to have definable limits. Rehabilitation is possible for many patients disabled by postoperative dysphagia. A transoral surgical technic for reconstruction of the obliterated pyriform sinus is described.

Deglutition Disorders↗
PubMed1978

Frozen autogenous mandible as an immediate replacement graft.

A study in animals was designed to examine the feasibility of grafting autogenous frozen mandible. Two groups of animals were used. In the first group, periosteum was elevated from the bone before resection. In the second group, the periosteum was removed with the resected specimen. Osteogenesis was shown by clinical, radiographic, fluorescence, and histologic studies in both groups of animals. The same technique was performed in nine humans with carcinomas that involved the mandible. The results were encouraging. We believe that immediate or delayed reconstruction with autogenous frozen mandible in a patient undergoing ablative surgery of the head and neck with involvement of the bone may offer the patient, as well as the surgeon, another acceptable treatment modality.

Animals↗
PubMed1976

Cryosurgery for oral cancer--a six-year retrospective study.

In a review of 50 patients with oral cancer treated by cryosurgery, local control of the tumor for more than two years was achieved in 90%. In only 4 of 25 instances where the tumor had superficially invaded bone, or was adjacent to it, was resection necessary. Cryosurgery was effective in controlling benign and premalignant lesions also. The treatment is often palliative and sometimes curative when patients refuse other recommended care.

Aged↗
PubMed1975

Postmaxillectomy rhinorrhea: corrected by transposition of parotid duct opening.

Two patients experienced chronic rhinorrhea following maxillary resection for cancer. This annoying symptom had been persistent for 12 and 13 years, respectively. Transposition of the parotid duct orifice on the operated side from a position lying above the maxillary prosthesis to a point below the prosthesis brought relief. Both patients had endured this nuisance for many years thinking it was a normal sequela of their operation. Multiple physicians had failed to identify the problem.

Carcinoma, Squamous Cell↗