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Biomedical subjects

D K Nosan

Publications and source records attributed to D K Nosan.

5 recordsLinked to original sources
PubMed1997

Current perspective on temporal bone trauma.

The improved survival of patients sustaining massive head injuries has increased the number of temporal bone fractures being managed by otolaryngologists and neurosurgeons. We performed a prospective analysis of 35 patients with head injury with temporal bone trauma. The major emphasis of this study was to investigate the incidence, management, and outcome of facial nerve injury in such patients and to evaluate the importance of electrodiagnostics in the surgical management of the facial nerve. The results of this study indicate an incidence of fracture type, hearing loss, and facial nerve paralysis similar to that already recorded in the literature. This study underscores the importance of evoked electromyography, or electroneuronography, in assessing facial nerve function. Electroneuronography provided the indications for surgical intervention for facial paralysis. All patients having surgery for facial paralysis as determined by electroneuronographic findings had pathology of the facial nerve.

Decompression, Surgical↗
PubMed1993

Perioperative stroke in patients undergoing head and neck surgery.

The risk of perioperative strokes has been demonstrated to be very low in general surgical procedures, and somewhat higher in cardiac and carotid artery procedures. We describe 5 patients who underwent major head and neck procedures not requiring carotid ligation and who postoperatively suffered strokes. These occurred between the first and ninth postoperative days. Four of the patients were thought to have had emboli, 3 to the cerebral hemispheres (2 ipsilateral and 1 contralateral to the neck dissections), and another to the lower brain stem. Hypoperfusion was thought to have caused the stroke in the fifth patient. All patients had risk factors for stroke. The cases in our series were difficult to diagnose because of the delayed onset and subtle nature of symptoms, as well as masking of speech and communication due to the operative involved. Thrombogenesis within the internal carotid and vertebral artery systems due to patient positioning and intraoperative cervical manipulation may be an important etiologic factor in this form of stroke.

Aged↗
PubMed1991

Preservation of facial contour during parotidectomy.

Parotid surgery often leaves a facial contour deformity. Free abdominal dermal-fat grafts were used to preserve the facial contour of nine patients undergoing parotid surgery. This procedure is simple to perform and provides an improved cosmetic result without significantly increasing operative time or lengthening hospitalization. No troublesome fat absorption occurred postoperatively. The dermal-fat graft also serves as a barrier to regenerating neurons, thereby preventing postoperative gustatory sweating.

Abdomen↗
PubMedDate not supplied

Intraoperative transcranial Doppler ultrasound in head and neck surgery: a preliminary report.

PURPOSE: To evaluate the possible role of intraoperative cerebral emboli in the origin of perioperative stroke during major head and neck surgical procedures. MATERIALS AND METHODS: Eleven patients undergoing major head and neck surgery that involved direct manipulation of the carotid sheath were the participants in this study. Transcranial Doppler (TCD) ultrasound was used intraoperatively to detect possible cerebral emboli. The presence or absence of intraoperative cerebral emboli in each patient was assessed by the presence or absence of typical embolic signal patterns within the TCD waveform. RESULTS: No intraoperative cerebral emboli were noted in the series, nor did any patient have a postoperative stroke. CONCLUSIONS: No intraoperative cerebral emboli were noted by using TCD ultrasound for embolus monitoring in patients undergoing major head and neck surgery involving carotid sheath manipulation. This detection system is easily used in appropriate head and neck cases and allows real-time, noninvasive intraoperative monitoring.

Adult↗