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Biomedical subjects

E N Myers

Publications and source records attributed to E N Myers.

At least 19 recordsLinked to original sources
PubMed1992

Transmandibular approaches to the oral cavity and oropharynx. A functional assessment.

The records of patients undergoing transmandibular approaches to soft-tissue carcinoma of the oral cavity and oropharynx were reviewed retrospectively. Thirty-nine patients requiring lateral segmental hemimandibulectomy and 45 patients requiring a mandibulotomy were identified. None of the patients given mandibulectomy underwent bone reconstruction, while all of the patients with mandibulotomy had repair at the completion of the case. A total of 53 patients were available for recall and functional assessment. Patients with mandibulotomy did not experience significant dysfunction of the temporomandibular joint. Patients with mandibulectomy demonstrated increasing amounts of eccentric occlusion; however, this did not affect diet and was not reported to be uncomfortable by these patients. When feasible, preservation of the mandible yielded an improved aesthetic result; however, functional results in patients requiring mandibulectomy compare favorably with those obtained after mandibulotomy and repair.

Adolescent↗
PubMed1992

The suprahyoid approach for squamous cell carcinoma of the base of the tongue.

The suprahyoid pharyngotomy is a well-recognized surgical approach to the base of the tongue. However, its use has been widely criticized for squamous cell carcinomas. Some surgeons believe this approach offers limited exposure and that violating the preepiglottic space increases the risk of recurrence. A retrospective study of squamous cell carcinoma of the base of tongue was carried out to address these surgical concerns. Nineteen patients presented with T1 or T2 lesions, 13 of whom underwent suprahyoid pharyngotomy with neck dissection. Those with nodal disease underwent adjunctive irradiation therapy and those with extracapsular spread also received subsequent adjuvant chemotherapy. At present, all patients are disease free. The suprahyoid pharyngotomy is an ideal surgical approach in the management of T1 or T2 squamous cell carcinoma of the base of tongue.

Aged↗
PubMed1992

Microvascular free tissue transfer for reconstruction of head and neck cancer defects.

Over the last 10 years, microvascular free tissue transfer techniques have broadened the range of the head and neck surgeon, allowing for successful reconstruction of extensive curative extirpations in one operation with minimal morbidity. Success rates of more than 90% are now being achieved consistently. This article provides an overview of these revolutionary techniques for oral cavity, mandibular, and hypopharyngeal reconstructions. Patients are selected for microvascular free tissue transfer because of the large size of their defect, its location (eg, anterior mandibular loss), or complexity (circumferential defects of the hypopharynx). Others may be good candidates for this surgery because of previous radiotherapy or failed reconstructive surgery. Donor sites range from the radial forearm to the jejunum.

Follow-Up Studies↗
PubMed1979

Anterior skull base surgery for benign and malignant disease.

Teamwork between the head and neck surgeon and the neurosurgeon utilizing the craniofacial resection technique greatly extends the frontiers of surgery for tumors of the anterior half of the skull base. Tumors for which this technique may be used include benign and malignant tumors arising in the frontal bone or frontal sinus, nasal vault, ethmoid, maxilla, sphenoid or orbit. Selected nasopharyngeal lesions such as angiofibromas with anterior or middle fossa extensions and sphenoid or clival chordomas may also be approached in this manner. This report evaluates the surgical techniques currently in use for managing these tumors, by discussing the benefits of combined resection, technical modifications of the techniques, and the results of using these techniques in 12 patients. The initial results are encouraging.

Adolescent↗
PubMed1978

Prosthetic reconstruction following resection of the hard and soft palate.

The restoration of the soft palate presents a challenge completely different from that of the hard palate. The mobility of the soft palate tends to interfere with velar extensions. The reduction in size of the soft palate extension to prevent impingement upon the mobile margins of the defect will lead to insufficient oronasal separation during functional activities. The solution is to construct a specially designed prosthesis to attain the maximum utilization of the remaining structures and their motility. Although each pharyngeal extension is different in shape, they give the patient an effective functional mechanism that enhances speech and swallowing.

Humans↗
PubMed1978

The masquerade of vasculitis: head and neck diagnosis and management.

Wegener's granulomatosis and forms of giant cell arteritis result from vasculitis and masquerade with symptoms of common head and neck disease entities. Recognition of the manifestations of vasculitis can be made early in the disease course and confirmed pathologically, allowing effective therapy. Current therapy of Wegener's granulomatosis with Cytoxin and Imuran and steroids for giant cell arteritis frequently results in reversal of head and neck involvement, prevention of systemic disease, and prolonged survival.

Aortic Arch Syndromes↗
PubMed1977

Intermaxillary fixation following mandibular resection.

This report concerns 14 patients who were treated by use of immediate intermaxillary fixation after segmental resection of the mandible to eradicate cancerous lesions. Mandibular resection usually produces problems in surgical and prosthetic reconstruction. The use of intermaxillary fixation during the first 6 postoperative weeks will reduce the degree of deviation. In mandibular resection for edentulous patients, the original dentures were used postoperatively with slight modification or no modification at all. With fixation and encouragement of early functional movement of the mandible, the dentulous patients showed a lesser degree of deviation. Some of the patients of the latter group used guide flange prostheses during the postoperative period to return the mandible to the centric position. Edentulous patients who deviated slightly were fitted with a maxillary ramp which guided the mandibular segment, after the initial contact, into the proper centric relation.

Carcinoma, Squamous Cell↗
PubMed1977

Surgical management of vagal chemodectomas.

Vagal chemodectomas (tumors of the vagal glomus body) are histologically benign and insensitive to radiation therapy. Unless properly managed, these tumors may become life-threatening because of their eventual impingement on surrounding structures, particularly contents of the cranial vault. Patients with chemodectomas of the skull base may be surgically treated without significant functional or cosmetic loss, provided the surgeon possesses the following surgical abilities: 1. temporal bone dissection capabilities; 2. microsurgical skills, including techniques of middle ear reconstruction and neurovascular anastomosis; 3. implementation of simultaneous multiple approaches to the skull base and infratemporal fossa; and 4. the capability of managing technically inherent intraoperative and postoperative problems. Experience from nine patients, all successfully treated surgically, will be summarized.

Adult↗
PubMed1976

Transantral-ethmoidal decompression of optic canal fracture.

A case of indirect trauma to the optic nerve was successfully treated with transethmoidal decompression. The literature was reviewed, and reports of poor results from neurosurgical procedures are cited. Improved results from transethmoidal decompression of the optic nerve have been reported by Japanese authors but, in our opinion, without proper selection of cases. Early diagnosis of traumatic compression of the intracanalicular optic nerve as evidenced by delayed and/or progressive vision loss following injury, coupled with prompt transantral-ethmoidal surgical decompression, should yield gratifying results in the treatment of this uncommon condition.

Adult↗
PubMed1976

Herniation of the singular nerve into the round window niche.

We report two cases of herniation of the singular nerve into the round window niche and one case of bony dehiscence without herniation between the round window niche and the posterior canal ampulla. It is believed that the middle ear and the inner ear are completely separate. However, in the temporal bone of a 10- to 15-week-old human fetus, a communication between the round window niche and the posterior canal ampulla is observed. Later, the mesenchymal tissue in the communication is replaced by cartilage from near the posterior canal ampulla. If the communication does not fill with cartilage, ossification is not able to begin behind the posterior canal crista. When there is bony dehiscence behind the crista, the singular nerve fibers are easily pressed out by ossified endosteal bone and herniated into the round window niche.

Ear↗
PubMed1976

Rhabdomyoma of the pharynx.

The occurrence of a large pharyngeal rhabdomyoma in an otherwise healthy adult male is discussed in this paper. This lesion, except for local symptomatology, is established as benign. A differential diagnosis, as well as the specific surgical approach to its removal, are also presented.

Diagnosis, Differential↗
PubMed1976

Lymphangiomatous macroglossia.

Lymphangiomatous macroglossia, or giant tongue, usually presents within the first two years of life. The tongue enlarges to the point of protrusion from the mouth with resultant ulceration and frank necrosis of the tip. There may be associated malocclusion and prognathia produced by the enlargement of the tongue. The pathology and clinical manifestations of lymphangioma of the tongue are discussed in this paper, and a case report is presented.

Child↗
PubMed1976

Metastasis of malignant melanoma of the nasal mucosa to the small intestine.

Malignant melanoma of the mucous membranes is rare and has a very poor prognosis. When localized in the nose, the tumor becomes apparent late in the course of the disease with nasal obstruction and epistaxis. Distant metastases are uncommon, but any organ of the body can be involved. A case of a malignant melanoma of the nasal mucosa with metastasis to the small intestine is presented, and the natural history of the metastatic disease is discussed.

Aged↗
PubMed1975

Necrotizing sialometaplasia. Report of a case.

Necrotizing sialometaplasia occurred in a 46-year-old woman. This is an uncommon benign disease that typically begins with an ulcerated lesion on the hard palate and surrounding tissues. Clinical and microscopic findings show obvious similarity with a malignant neoplasm. Necrotizing sialometapiasis is a benign minor salivary gland disease. It is important since it may easily be confused with squamous cell carcinoma and mucoepidermoid carcinoma.

Carcinoma↗
PubMed1975

Management of chylous fistulas;.

Chylous fistula following radical neck dissection is a disturbing and potentially serious complication. Meticulous surgical technique in the areas of the thoracic duct on the left and the lymphatic ducts on the right will usually prevent the occurrence of a chylous leak. If one should develop, however, a pressure dressing alone is usually not sufficient to tamponade the leaking vessel. The patient should be returned to the operating room where the leak is identified and ligated. Loss of chyle from the body will rapidly deplete the body stores of fluid, proteins, and electrolytes. Careful monitoring of serum electrolytes and proteins and accurate replacement of these substances is essential. The anatomy, physiology, surgical technique, and treatment of the lymphatics and chylous fistulas at the base of the neck are considered herein.

Chyle↗