Biomedical subjects

C P Hybarger

Publications and source records attributed to C P Hybarger.

5 recordsLinked to original sources

PubMed1994

The Rintala flap revisited.

We describe nasal tip reconstruction using a superiorly based midline Rintala flap. Good tissue coverage and excellent flap viability, color match, and nasal contour make this flap a good alternative for reconstructing large nasal tip defects without using forehead flaps. Up to half the superior columella can be reconstructed simultaneously by using this single-stage technique with the patient under local anesthesia. Adjunctive procedures such as tip rhinoplasty and bilateral cheek flap advancement can add to the utility of this flap and are discussed along with general techniques and case examples.

Aged↗

PubMed1993

Osteomyelitis of the jaw in patients infected with the human immunodeficiency virus.

Eight patients with osteomyelitis of the jaw were identified at two county hospitals over a 4-year period. Three patients (37.5%) were found to be HIV-seropositive, including two patients not previously known to be HIV-seropositive. Signs and symptoms of infection were similar in both groups of patients, and commonly included fever, pain, and swelling. Radiographs showed specific findings of osteomyelitis in one of three HIV-seropositive patients and four of four seronegative patients with chronic jaw infection. HIV-seropositive patients appeared to have a worse clinical outcome than their seronegative counterparts. We conclude that osteomyelitis of the jaw may be the presenting manifestation of HIV infection, and that careful attention and close follow-up should be applied to such patients because of their poor overall clinical response.

Adult↗

PubMed1992

Ultrasonography of cystic parotid lesions in HIV infection. Similarity of sonographic appearance with Sjögren's syndrome.

Bilateral cystic parotid glands occur in some cases of human immunodeficiency virus (HIV) infection. This abnormality, which is associated with cervical adenopathy, can be defined by sonography in the superficial gland, as noted in three men. In retrospect, this parotid disease has similarity to the sonographic finding of Sjögren's syndrome, except for the finding of cervical adenopathy, an observation not previously appreciated.

Adult↗

PubMed1987

Carcinoids associated with multiple endocrine neoplasia syndromes.

Carcinoids occur in association with MEN types 1 and 2. To determine the relationship between carcinoids and MEN, we reviewed nine patients with carcinoids and other endocrine tumors. Analyzing these 9 patients and 56 other patients previously described in the literature, we found several clinically important relationships. In contrast to the usual midgut and hindgut origin, most carcinoids associated with MEN (69 percent) are of foregut origin (thymus 24 percent, bronchus 27 percent, stomach 3 percent, and duodenum 14 percent). Carcinoids are more commonly associated with MEN type 1 than MEN type 2 (59 patients and 6 patients, respectively). Thymic carcinoids associated with MEN are more common in men (15 versus 2), and most (82 percent) are malignant. Bronchial carcinoids associated with MEN are more common in women (15 versus 4), and most (74 percent) are benign. There is a strong association between thymic carcinoids and parathyroid tumors and between bronchial carcinoids and pituitary tumors. Most patients with carcinoids and hyperparathyroidism (82 percent) have had parathyroid hyperplasia or multiple parathyroid adenomas. Thus, carcinoids may occur in association with both MEN type I and MEN type II. MEN should be suspected in patients with foregut carcinoids. Patients with MEN and ectopic ACTH production should be considered to have bronchial carcinoids if they are female and thymic carcinoid if they are male. The thymus should be routinely removed in patients with MEN type I because of the possible presence of an ectopic parathyroid gland in this tissue and to prevent subsequent development of a carcinoid tumor.

Adolescent↗

PubMedDate not supplied

Triple-flap technique for reconstruction of large nasal defects.

OBJECTIVE: To determine the usefulness of a triple-flap technique for repair of large zone 2 Mohs defects of the nose. METHODS: The triple-flap technique was performed on 10 fresh adult cadaver heads that had been injected intravascularly with blue dye. Two distances were measured and recorded: (1) the distance from the most lateral portion of the alar crease to the transverse facial artery; and (2) the distance from the dorsal nasal artery to the medial canthi. Data were also collected on patient age and sex and on the size of the Mohs defect in a series of 10 patients. RESULTS: The cadaver study showed that the dorsal nasal artery was located a mean distance of 7.4 mm superior to the medial canthal tendon and that the transverse facial artery was located a mean distance of 19.2 mm lateral to the alar crease. In our series of 10 patients (2 of whom are described herein), zone 2 defects (including full-thickness unilateral alar defects) as large as 3.5 x 5.0 cm were reconstructed in 1 stage using local anesthesia. No flap loss resulted. CONCLUSIONS: Cadaver dissection enabled us to identify the blood supply of the dorsal nasal flap in relation to the medial canthal tendon and the blood supply to the superior melolabial flap in relation to the alar crease. For a select group of patients with large zone 2 Mohs defects of the nose, the use of the triple-flap technique to repair the defect is a viable alternative to the use of a forehead flap technique.

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