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Biomedical subjects

F G Wolfort

Publications and source records attributed to F G Wolfort.

12 recordsLinked to original sources

Chondrolaryngoplasty for appearance.

Prominent thyroid cartilage (pomus Adamus) is frequently a constant embarrassment to the male transsexual as well as to the asthenic male. The demand for reduction and contouring of the pomus Adamus continues to increase in our societies today. Since our first presentation of this procedure, we have been able to follow 31 patients over a 17-year period. We present a review of our technique of chondrolaryngoplasty, with anatomic details and a follow-up of 31 patients ranging from 4 months to 17 years. The results are effective and satisfying, with few complications. Those which do occur tend to be transient, with the most frequent being a temporary mild voice weakness. We believe this operation has a place among the techniques of plastic surgeons.

Adolescent

Torticollis.

Torticollis can be an isolated deformity or a sign of other neuromuscular disease. Underlying central nervous system or infectious disorders need to be considered and treated. In most patients, an improvement in the aesthetic disability is the primary objective. In general, an operation is indicated for the classical "congenital" muscular torticollis that does not respond to physiotherapy and forceful stretching of the restricting neck band. The mass or "tumor" of "congenital" torticollis requires no specific treatment. Operation may be delayed until age 1, but should probably be completed prior to school age. Reversal of craniofacial asymmetry is best achieved at an early age when there is maximum growth potential. Principles of surgery are (1) identification and release of all restricting bands involving the sternocleidomastoid muscle and other neck structures, (2) moving of the head and neck through a full range of motion prior to the completion of the procedure, and (3) resumption of physical therapy within 2 weeks of operation to prevent recurrent scar contracture. Various operations have been recommended, the most popular and reliable being inferior open tenotomy of the sternal and clavicular heads of the sternocleidomastoid muscle. Incisions should be placed low in the neck along skin lines and not over the clavicle in order to avoid hypertrophic scarring. Other procedures discussed are superior open sternocleidomastoid tenotomy (mastoid release), muscle lengthening procedures, and sternocleidomastoid excision. Only modest results should be anticipated in older children or adults with long-standing disease or advanced craniofacial asymmetry.

Humans

Multiple familial angiolipomatosis: treatment of liposuction.

Lipomas constitute the most common soft-tissue tumors [11] and may occur sporadically or as one of several inherited disorders. Benign fatty tumors can be classified into three major categories: solitary lipomas, familial multiple lipomatosis, and congenital diffuse lipomatosis [4]. The latter has also been referred to as multiple symmetric lipomatosis, Madelung's disease, or Launois-Bensaude syndrome. Within the categories a more vascular varient of the lipoma, the angiolipoma, has been described separately by some authors, but in many reports it is not distinguished from a lipoma. Liposuction has been used for the treatment of solitary lipomas, but to our knowledge liposuction has not previously been reported for excision of angiolipomas or in familial cases involving multiple lipomas as described here.

Adipose Tissue

Resection of tumors in irradiated fields with subsequent immediate reconstruction.

With increased use of primary radiation therapy for treatment of cancer and adjuvant radiation therapy after surgical removal of a bulk tumor, recurrence in these fields has posed significant new and increasingly technical and biologic problems. We report our experience with ten such cases in which difficult wounds were reconstructed immediately after major regional resections of advanced or recurrent tumors in fields of previous irradiation. All of these patients could undergo extirpation of their recurrent tumors in irradiated fields because of improved techniques in reconstructive flap surgery allowing large amounts of well-vascularized tissue to be transferred, sometimes over a significant distance. Follow-up of these patients has ranged from three to 18 months (median, nine months). Primary healing, decreased deformity, reduced morbidity, and prolonged disease-free intervals have been achieved with the combination of extirpative and reconstructive techniques.

Abdominal Neoplasms

Correction of the inverted nipple.

The inverted nipple has been attributed to hypodevelopment of both nipple and areolomamillary musculature. A number of procedures have been devised to correct this deformity for the purposes of nursing and also for cosmesis. Excision of the entire areola, myotomy of areolomamillary bundles, and partial areolar excision in apposing quadrant triangles have all been used. An operative technique has been designed reflecting some of the older methods and an innovation utilizing areolar V-Y plasties and purse-string sutures to the nipple base for support. This method avoids excision and consequent extensive scarring of the areola. This procedure has been found to have satisfactory functional and cosmetic results in clinical trials to date.

Breast

Immediate insertion of silicone rubber rods in fingers with cut flexor tendons.

In 7 patients with cut flexor tendons of the hand, we did an immediate quantitative bacterial analysis of the wounds. These showed fewer than 10(5) bacteria per gram of tissue, so we inserted silicone rubber rods in 10 of these fingers. All healed without infection, and this shortened the reconstruction. In retrospect, we believe it best not to insert the rods primarily in crush injuries. However, this seems to be a safe, worthwhile measure for those patients with sharp injuries of the tendons.

Finger Injuries

Experience with interposition mesocaval shunt for management of variceal bleeding.

We present an experience with 20 patients undergoing interposition mesocaval shunts for decompression of esophageal varices. There were 14 men and six women, ranging in age from 32 to 80 years. Two patients were classified as good risks, nine as moderate risks, and nine as poor risks. There were ten elective operations, seven urgent operations, and three emergency procedures. An operative mortality of 10% was noted in the entire group, with one late death due to shunt occlusion. All deaths occured in the emergency group. A shunt patency of 88% and minimal problems with postoperative hepatic encephalopathy were noted. The interposition mesocaval shunt is judged to be a safe, technically easy procedure that is currently a satisfactory solution to the problem of hemorrhage from esophageal varices.

Adult

When is there nipple involvement in carcinoma of the breast?

Two hundred cases of carcinoma of the breast were examined to determine the extent of nipple involvement. Carcinoma was present in 8 percent of the specimens. Fourteen of the 16 nipples which contained tumor were macroscopically abnormal in reappearance--being either ulcerated, retracted, or attached to an underlying indurated mass. Clinically normal niples are not likely to contain carcinoma. A frozen section across the nipple base should also be used as a safeguard if the nipple is to be used in reconstruction.

Adenocarcinoma