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Biomedical subjects

Daniel G Deschler

Publications and source records attributed to Daniel G Deschler.

25 records · Page 2Linked to original sources
PubMed2003

Lymphomas.

Hodgkin's and non-Hodgkin's lymphomas are an important part of the differential diagnosis of head and neck tumors. Their diagnosis begins with a complete history and physical examination and is confirmed with an appropriately obtained and prepared pathologic specimen. Prognosis and therapy of the lymphomas vary depending on stage and the characteristics of each particular subtype of lymphoma. Low-grade lymphomas and chronic lymphocytic leukemia are characterized by long survival times and are most often treated with palliative intent. More aggressive high-grade lymphomas are treated for cure. Although chemotherapy and radiotherapy remain the mainstays of treatment, immunotherapy demonstrates increasing promise.

Head and Neck Neoplasms↗
PubMed2002

Temporary intraoperative external fixation in mandibular reconstruction.

OBJECTIVES: To describe the use of a temporary intraoperative external fixation device to assist in the optimal bony reconstruction of the mandible in the setting of vascularized bone grafts. STUDY DESIGN: A retrospective review of six patients who underwent composite resection of the mandible and subsequent reconstruction with osteocutaneous free tissue transfer in a tertiary care center. METHODS: Six cases of mandibular reconstruction using an intraoperative external fixation system to assist the positioning of vascularized bone grafts are presented. All patients had composite resection of the mandible and subsequent reconstruction with either a scapula or fibula osteocutaneous flap. Follow-up ranged from 2 to 16 months. RESULTS: Successful reconstruction as defined by acceptable contour, occlusion, and condylar position was achieved in all cases. Complications were limited to a postoperative cerebrovascular accident requiring anticoagulation and subsequent neck hematoma. CONCLUSIONS: Use of intraoperative external fixation maintains the proper alignment of mandibular segments without the use of a bridging reconstruction plate. This technique is particularly valuable with tumors involving the outer cortex of the mandible.

Aged↗
PubMed2002

Emergency department management of foreign bodies of the external ear canal in children.

OBJECTIVE: To evaluate the management of foreign bodies in the external auditory canal (EAC) in pediatric patients by emergency department personnel. SETTING: Tertiary care pediatric hospital emergency department. STUDY DESIGN: A retrospective chart review of children with foreign bodies of the EAC over a 12-month period. Age, foreign body type, rate of successful removal, and complication rates were recorded. Foreign bodies were categorized into two groups: objects with smooth surfaces and not easily grasped (nongraspable) and objects with irregularly shaped surfaces and easily grasped (graspable). RESULTS: Thirty-six patients were brought to the emergency department over a 12-month period with foreign bodies of the EAC. Their mean age was 6.5 years (range, 1-16 yr). Numerous foreign bodies were noted; beads were the most common. Successful removal was achieved in 53% of cases, and one or more complications were recorded in 47%. When the foreign bodies were grouped into nongraspable and graspable objects, the success rate for the nongraspable group was 45%, with a complication rate of 70%, whereas for graspable objects the successful removal rate was 64%, with a complication rate of only 14%. The difference in complication rates was statistically significant (p < 0.001.) CONCLUSION: This study demonstrates that certain foreign bodies (graspable type) of the EAC in pediatric patients can be successfully managed by skilled emergency department personnel with low complication rates, whereas other foreign bodies (nongraspable types) may be better managed by early referral to an otolaryngologist.

Adolescent↗
PubMed2002

First report of a lipoblastoma of the parapharyngeal space.

Lipoblastoma is a rare benign tumor that occurs primarily in children younger than 3 years of age. Fewer than 100 cases have been reported in the literature, and only eight cases have been previously reported in the head and neck; two of them occurred in the parotid region, where the differential diagnosis becomes quite extensive. We report a new case of head and neck lipoblastoma--one that occurred in the parapharyngeal space, a site that has not been previously reported. By doing so, we hope to promote awareness and consideration of lipoblastoma in the differential diagnosis of deep-parotid and parapharyngeal-space neoplasms.

Biopsy, Needle↗
PubMedDate not supplied

The effect of subcutaneously administered low-molecular-weight heparin on microarterial thrombosis in the rat.

OBJECTIVE: To examine the effect of administration of a low-molecular-weight heparin derivative, enoxaparin, on the rate of arterial thrombosis in a rat model. STUDY DESIGN: Prospective, randomized, blinded study. METHODS: A standard microarterial anastomosis tuck injury was created in both femoral arteries of 25 Long Evans retired breeder rats. Thirteen animals received a subcutaneous injection of 50 IU/kg of enoxaparin 2 hours before the procedure, while 12 control animals received vehicle (isotonic sodium chloride solution) alone. Sites of injury/repair were assessed 2 hours after the procedure for anastomotic patency or thrombosis. RESULTS: Six (23%) of 26 vessels in the drug-treated group developed an arterial thrombosis at the site of repair, while 6 (25%) of 24 vessels in the control group developed thrombosis. There was no statistically significant difference at the 95% confidence limit between the 2 groups based on a comparison-of-proportions test. CONCLUSION: The preoperative subcutaneous administration of 50 IU/kg of enoxaparin did not alter the rate of arterial thrombosis following the creation of a thrombogenic tuck injury/repair of the rat femoral artery.

Animals↗
PubMedDate not supplied

The effect of low-molecular-weight heparin on microvenous thrombosis in a rat model.

OBJECTIVE: To assess the impact of a low-molecular-weight heparin sodium, dalteparin sodium, on a thrombogenic microvenous anastomosis, using a randomized, blinded animal model. METHODS: Using male Sprague-Dawley rats, 70 IU/kg of dalteparin sodium (for the treatment group) or isotonic sodium chloride solution (for the control group) were administered subcutaneously in a blinded randomized fashion. Using microsurgical techniques, the femoral venous pedicle was isolated bilaterally. A tuck anastomosis was then performed on each side. Vessel patency was assessed periodically for 3 hours using a strip and refill test. Patency or thrombosis was confirmed by cutting the vessel proximal to the anastomosis and examining the lumen for thrombus. RESULTS: A total of 58 venous tuck anastomoses were performed. There was no difference in bleeding complications between the treatment and control groups. The control group had a thrombosis rate of 50%, and the treatment group had a thrombosis rate of 60%. The chi2 analysis does not indicate a statistical difference between these 2 groups (P = .59). CONCLUSION: Low-molecular-weight heparin, at standard therapeutic dosing, may not provide an adequate antithrombotic effect to prevent anastomotic thrombosis in free tissue transfer.

Anastomosis, Surgical↗