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Biomedical subjects

E A Dolan

Publications and source records attributed to E A Dolan.

At least 19 recordsLinked to original sources
PubMed1992

No effect of neuromuscular blockade on the temporomandibular joint position during general anesthesia.

In an attempt to determine the role that nondepolarizing neuromuscular blocking agents play in the intraoperative position of the mandibular condyle, occlusal checkbites were taken on 10 patients under general anesthesia before and after neuromuscular blockade with vecuronium. These checkbites were compared to checkbites taken preoperatively. Nondepolarizing neuromuscular blocking agents had no effect on condylar position recordings during general anesthesia. The results demonstrate that general anesthesia itself is by far the dominant factor in intraoperative condylar position changes.

Anesthesia, General↗
PubMed1991

Dental lesions in tumoral calcinosis.

Tumoral calcinosis (TC) is a rare inherited autosomal dominant metabolic disease manifested by elevated serum phosphorus and 1,25 dihydroxyvitamin D levels and periarticular cystic and solid tumorous calcifications. The dental findings in a large family have been critical in determining the genetic transmission of the condition. Radiographically the teeth have short bulbous roots, pulp stones and partial obliteration of the pulp cavity. Histologically, coronal dentin and a variable amount of radicular dentin appears to be deposited regularly. At nonspecific points the developing radicular dentin appears to encounter a mass of calcified material and proceed to grow around it. This mass has a unique histologic pattern with ovoid spaces surrounded by amorphous calcification. At levels of further root development the radicular dentin has an irregular bending tubule arrangement. The dental lesion of TC appears to be different from that of radicular dentin dysplasia in histologic structure and in the method of initiation of the dentin defect. These data suggest that the specific dental lesion is a new phenotypic marker for TC.

Adolescent↗
PubMed1990

Ankylosing spondylitis associated with temporomandibular joint ankylosis: report of a case.

Ankylosing spondylitis is a disease process that causes inflammatory changes of the involved joints. Often the first clinical indication of the condition is lumbosacral pain and discomfort with limited range of motion. Progressive synovial changes eventually involve all of the axial joints including the temporomandibular joint. Although temporomandibular joint dysfunction is usually found in patients with ankylosing spondylitis, there are only nine documented cases of true bony ankylosis. A case report and review of the literature of ankylosis spondylitis associated with true temporomandibular joint bony ankylosis is presented. Surgical treatment included a gap arthroplasty and placement of an interpositional Silastic implant.

Arthroplasty↗
PubMed1989

Continuous infusion of methohexital and alfentanil hydrochloride for general anesthesia in outpatient third molar surgery.

Three anesthetic techniques were compared in this study: 1) Intermittent Brevital boluses supplemented with fentanyl and midazolam all titrated to patient movement, 2) constant infusion of Brevital supplemented with fentanyl and midazolam all delivered in calculated mg/kg doses based on total body weight, and 3) constant infusion of methohexital (Brevital) and alfentanil (Alfenta) supplemented by midazolam (Versed), droperidol, and glycopyrolate (Robinul) delivered in calculated mg/kg doses based on lean body mass. Nitrous oxide was delivered in all cases via nasal mask in a 30% to 50% concentration. The mean total dose of Brevital in group 1 (intermittent Brevital bolus) was 0.17 mg/kg/min (SD = 0.07), group 2 (Brevital infusion) was 0.23 mg/kg/min (SD = 0.06), and group 3 (alfentanil/Brevital infusion) was 0.12 mg/kg/min (SD = 0.07). Mean total dose of alfentanil in group 3 equaled 1.58 mcg/kg/min (SD = 0.73). In group 1, 94% of the patients experienced moderate to severe movement intraoperatively. Twenty-three percent of the patients in group 2, and only 7% of group 3 exhibited moderate to severe movement. Emergence in group 3 averaged 4.5 minutes (SD = 1.6). Three patients (7%) in group 3 had postoperative nausea. Additional subjective findings in group 3 included easier airway maintenance during administration of the anesthetic, lack of unpleasant emergence phenomena such as crying, and prompt readiness for discharge. It was concluded that continuous alfentanil and Brevital infusion satisfied the objectives of safety, stability, predictability, and rapid recovery, while improving operating conditions (less patient movement) when compared with more traditional anesthetic techniques.

Adult↗
PubMed1989

Macroglossia: clinical considerations.

Macroglossia is a multifactorial condition that is almost always associated with a space-occupying mass of the tongue. The usual treatment is surgical resection. The typical medical conditions that lead to macroglossia have been described. The orofacial myologist should be alert to the presence of possible pathology of the tongue during orofacial examination, and refer suspected instances of macroglossia to an appropriate medical resource for definitive diagnosis and treatment.

Humans↗
PubMed1989

Correlation of magnetic resonance imaging and surgical findings in patients with meniscal perforation.

Advancement of surgical techniques has made it necessary to accurately diagnose internal derangements. Arthrography and computerized tomography have been used to diagnose the majority of temporomandibular joint disorders; however, these methods have had their disadvantages. Magnetic resonance imaging utilizing surface coils has greatly improved the ability to diagnose meniscus abnormalities without using interarticular injections or ionizing radiation. Ninety-two patients (184 joints) were evaluated by means of magnetic resonance imaging (MRI). Thirty-one patients (39 joints) were diagnosed as having meniscus perforation. Retrospective reviews of 15 patients (20 joints) with a perforated meniscus diagnosed by magnetic resonance imaging preoperatively demonstrated a 65% correlation between the radiographic diagnosis and the surgical findings.

Adult↗
PubMed1989

The role of pressure flow and endoscopic assessment in successful palatal obturator revision.

The purpose of this paper is to illustrate the value of combined aerodynamic and endoscopic examination of velopharyngeal function in the revision of prosthetic speech appliances. Use of these combined measures enables the clinician to identify accurately the site(s) of any under- or overobturation. Furthermore, any needed revision is completed accurately and efficiently.

Adult↗
PubMed1988

Double-blind comparison of nalbuphine and meperidine in combination with diazepam for intravenous conscious sedation in oral surgery outpatients.

Nalbuphine and meperidine were compared as analgesic components of intravenous conscious sedation in a double-blind, prospective trial of 47 patients undergoing elective oral surgery. Subjects were evaluated for pain intensity, pain relief, anxiety, sedation, recall, and vital signs at systematic observation points intraoperatively and postoperatively. At the conclusion of surgery 83% of patients who had received nalbuphine and 86% of patients treated with meperidine indicated complete pain relief. One observed adverse reaction was attributed to meperidine and another to the sedative component diazepam. No statistically significant differences were observed between nalbuphine and meperidine treatments.

Adult↗
PubMed1988

Comparison of nalbuphine and fentanyl in combination with diazepam for outpatient oral surgery.

Nalbuphine and fentanyl were compared as analgesic components of intravenous conscious sedation with diazepam in a double-blind, prospective trial of 50 patients undergoing elective oral surgery. Subjects were evaluated for intensity of pain, pain relief, sedation, anxiety, recall, and vital signs at systematic observation points intraoperatively and postoperatively. At the conclusion of surgery, 88% who received nalbuphine and 87% treated with fentanyl indicated complete pain relief. One observed adverse reaction was attributed to the combination of fentanyl and the sedative component diazepam. No statistically significant differences were observed between nalbuphine and fentanyl treatments.

Adult↗
PubMed1985

Genetic transmission of tumoral calcinosis: autosomal dominant with variable clinical expressivity.

Tumoral calcinosis is a rare inherited metabolic disorder characterized by hyperphosphatemia, elevated serum 1,25-dihydroxyvitamin D levels and periarticular cystic and solid calcifications. Based on previous investigations, the inheritance of this disorder has been postulated to be autosomal recessive. This interpretation was based on finding clinically affected subjects in only single generations of kindreds. We investigated four generations of an affected kindred and found nine subjects with the disease. A unique dental lesion which is specific for this disorder and serves as a phenotypic marker was identified in two generations of the kindred. In all affected subjects, elevated serum 1,25-dihydroxyvitamin D levels were found, although each member did not have the classical clinical findings of tumoral calcinosis. The possibility that this disorder may be variably expressed and have multiple formes frustes has not been previously considered. Using the unique dental lesion as well as the classical clinical and biochemical abnormalities, we found that in this kindred, tumoral calcinosis is transmitted in an autosomal dominant mode, with variable clinical expressivity.

Adolescent↗
PubMed1984

Styloid-stylohyoid syndrome in the differential diagnosis of atypical facial pain.

Differential diagnosis of atypical facial pain can be a perplexing problem. Similarities in symptomatology and nonspecific subjective findings make diagnosis difficult. The astute diagnostician, regardless of his speciality, must be acutely aware of key findings that will differentiate the myriad of chronic pain syndromes in his patients. Accurate correlation of clinical and radiographic findings in patients with "Eagle's syndrome" may assist the clinician in distinguishing this entity from other pain syndromes, such as glossopharyngeal or vagoglossopharyneal neuralgia.

Carotid Artery Diseases↗