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Biomedical subjects

D J Hodgkinson

Publications and source records attributed to D J Hodgkinson.

40 records · Page 3Linked to original sources

The influence of facial-nerve sacrifice in surgery of malignant parotid tumors.

Malignant parotid tumors in 224 patients were dealth with surgically at the Mayo Clinic between 1940 and 1969. The clinical histories, including follow-up of 5 years or more in every case, were reviewed with particular attention to sacrifice of the facial nerve in conjunction with the excision of tumor. This was done in 65 cases. High-grade malignancy necessitated nerve sacrifice; other frequent indications were preoperative facial-nerve paralysis, pain, and rapid growth of the tumor. Over the 30-year review period, the trend was toward more radical surgery, often including nerve sacrifice, and away from local excision and radiotherapy. Nerve grafting or anastomosis of a sacrificed nerve was seldom performed in an attempt to lessen the cosmetic defect of facial paralysis. Later reconstructive procedures are favored.

Adolescent↗

Upper limb emboli: a reappraisal.

Upper limb embolus cannot be regarded as a benign condition, with invariable recovery due to copious collateral circulation. Gangrene of the upper limb may occur, as shown in the series of cases in this report. The overall mortality rate remains considerable, because of associated cardiac disease, recurrent embolism, or both. Emboli proximal to the origin of the profunda brachii artery represent a group associated with higher risk, for which prompt embolectomy is often indicated. In embolism due to subclavian aneurysm and with thrombosis, arterial reconstruction should be undertaken, for multiple recurrence is likely. Long-term anticoagulant therapy is usually required to try to prevent recurrence of embolism if the primary source of the embolus remains.

Adolescent↗

Chest wall implants: their use for pectus excavatum, pectoralis muscle tears, Poland's syndrome, and muscular insufficiency.

Solid customized and prefabricated silicone implants have been used by the author for 15 years in a wide range of chest wall deformities. Chest wall implants are often used in males seeking to augment a muscularly deficient or underdeveloped chest; however, their greatest use has come in a variety of deformities both congenital and acquired, such as pectus excavatum, Poland's Syndrome, and pectoralis muscle tears. The implants can be either customized using a moulage technique or are prefabricated, manufactured implants which can be modified on the operating table to repair the contour deformity. The immediate postoperative problem of seroma and subcutaneous implant "show" has been minimized by careful planning, gentle technique, deep insertion, improved patient positioning on the operating room table, and the use of oral anti-inflammatory medications. The long-term results of these implants seem very satisfactory. The patients are usually physically active, and the implants show no long-term sequelae such as seroma, infection, displacement, or rupture.

Adolescent↗

Buckled upper pole breast style 410 implant presenting as a manifestation of capsular contraction.

Recent experience with the cohesive gel implant has shown an interesting variation of capsular contracture. Instead of spherical contraction, the capsule formation around the 410 implant seems to cause a buckling of the superior pole of the implant. This buckling has been observed in four implants and presented clinically in 2 of 50 patients with a superior pole mass. The capsular contraction around the implant and the buckling are probably camouflaged by a subpectoral implantation and this presentation should be recognized by the surgeon, especially when considering placement of the cohesive gel implant in a subglandular position. Histological sections of a capsule around the implant show fragmented silicone, with a cellular reaction around the fragmented silicone.

Breast Implants↗