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Biomedical subjects

H G Thomson

Publications and source records attributed to H G Thomson.

At least 19 recordsLinked to original sources
PubMed1990

Endoscopic evaluation and treatment of sleep-associated upper airway obstruction in infants and young children.

A method is described for observing the pharyngeal airway in children with proven sleep apnoea using a flexible nasendoscope during light anaesthesia. Fifteen children were referred for endoscopic evaluation and treatment. All had documented obstructive sleep apnoea. Flexible endoscopic assessment of the airway revealed the site of obstruction in all cases and allowed a rational and successful management plan. The mechanism of obstructive sleep apnoea in infants and young children is discussed and the findings at endoscopy and results of treatment are reported.

Adenoidectomy↗
PubMed1990

Common benign pediatric cutaneous tumors: timing and treatment.

This article has been a brief overview of some of the common cutaneous pediatric tumors. There are many that have been omitted, but these are relatively uncommon and, for them, consultation with your dermatologist and/or professional peers is always a good investment. This pays great dividends and increases the quality of health care, particularly in the uncommon lesions that are foreign to you but may have been seen on several occasions by one of your peers.

Child↗
PubMed1989

Cerebrospinal fluid in the rhinitis clinic.

The Rhinitis Clinic at the Royal National Throat Nose and Ear Hospital is a direct referral clinic dealing with approximately 300 new cases a year. Last year three cases of spontaneous CSF rhinorrhoea were diagnosed. In each case long term topical steroid sprays had been prescribed and the patients had been referred for further management of their 'rhinitis'. Spontaneous CSF rhinorrhoea is potentially life threatening as failure to recognize the problem may lead to the development of meningitis and possibly death. The diagnosis is simple and is based on a good clinical history which may be confirmed by chemical pathology. Radiology is often non-contributory, the site of the leak may have to be identified at surgery. Morbidity and mortality are reduced if an extracranial, trans-nasal/external ethmoid route for repair of the fistula is employed. Three case reports are presented and the diagnosis and management of CSF rhinorrhoea is reviewed.

Adult↗
PubMed1989

Reconstruction of cupid's bow: a quadrilateral flap technique.

The cupid's bow is an important feature of the normal upper lip, and every effort should be made to reconstruct it during initial cleft lip surgery or trauma repair. However, a secondary surgical procedure is often necessary to improve the appearance and symmetry in the cupid's bow area. For this purpose, the authors present a quadrilateral type of interposition flap that can be used in both unilateral and bilateral cupid's bow reconstruction. This procedure is applicable only when adequate vermilion is available.

Cleft Lip↗
PubMed1989

Microtia reconstruction: does the cartilage framework grow?

The use of free rib cartilage ear frameworks in unilateral microtia reconstruction has prompted much discussion about their potential for growth. The senior author has reconstructed ear frameworks in 132 microtia patients, most of whom were under 3 years of age when surgery was initiated. Of this group, 29 were assessed for ear growth through comparison of the lead-plate model of the original normal ear to the normal ear growth and the reconstructed ear framework after a period of at least 2 years. Similarly, 14 reconstructed ears were compared to 14 normal ears at least 2 years after reconstruction. The perimeters of tracings made from the original lead plates and of tracings of normal and reconstructed ears were determined by image analysis techniques. The results demonstrated no significant difference in growth between normal ears and reconstructed ear frameworks after an interval of at least 2.5 years. Therefore, the reconstructed ear is growing at a rate similar to that of the normal ear.

Cartilage↗
PubMed1988

The fate of sternotomy scars in children.

The scars from sternal split incisions were examined and rated in 101 consecutive children attending a cardiology clinic at least 1 year after surgery. Each scar was rated as excellent, good, acceptable, or poor. Factors that may correlate with scar quality were analyzed. This analysis showed that poor scars were most likely to have been closed with intracuticular polyglycolic acid suture; males were more likely to have better scars than females; the younger the child at operation, the better was the scar result; and only 18 of the 69 scars that were hypertrophic 1 year postoperatively remained so after a mean of 5.5 years.

Adolescent↗
PubMed1985

Pharmacologic action of isoxsuprine in cutaneous and myocutaneous flaps.

The therapeutic effects of isoxsuprine on skin capillary blood flow and viability were studied in arterial buttock flaps, latissimus dorsi myocutaneous flaps, and random skin flaps in pigs. It was observed that parenteral isoxsuprine increased capillary blood flow to the skin of arterial buttock flaps and the skin and muscle of latissimus dorsi myocutaneous flaps in a dose-response manner, with a maximum vascular effect observed at 1.0 mg/kg. However, this maximum effective dose of isoxsuprine did not have any significant effect on skin viability in the cutaneous and myocutaneous flaps compared with the control. Examination of the distribution of capillary blood flow within the flaps at varying distances from the pedicle revealed that isoxsuprine did not increase capillary blood flow or perfusion distance in the distal portion of the skin of arterial buttock flaps, latissimus dorsi myocutaneous flaps, and random skin flaps. The increased capillary blood flow as a result of isoxsuprine treatment was limited only to the arterial portion of the arterial buttock flaps and latissimus dorsi flaps. Therefore, it is concluded that isoxsuprine alone is not effective in augmentation of skin viability in cutaneous and myocutaneous flaps. The pharmacologic action of isoxsuprine on the vasculature in the skin and muscle of flaps was also discussed.

Animals↗
PubMed1985

Clinical evaluation of microform cleft lip surgery.

The definition of microform cleft lip and the dilemma surrounding its surgical correction were reviewed. A modified Williams method for assessing cleft lips was employed by two panels (each of four evaluators) with 24 patients who had similar deformities and corrective operations. In 20 patients the results appear to have justified the surgery, but in the remaining 4, who were less seriously deformed, the perceived improvement was minimal or even nonexistent. The perceptions and wishes of the parents and patient must also be considered in determining the success of this procedure, which was not done in this study.

Child↗
PubMed1985

The residual unilateral cleft lip nasal deformity: a three-phase correction technique.

The author presents a three-phase correction technique for the residual unilateral cleft lip nasal deformity. This procedure involves a sculpting excision of the alar rim, use of this alar rim as an interpositional flap in lengthening the columella, and augmentation of the nasal tip and perialar sulcus with a free ear conchal cartilage graft. The concept has been incorporated in the revisionary surgery program of 74 patients over a period of 5 years with a minimal follow-up of 2 years. The majority of the patients are operated on between the ages of 5 and 7 years based on the concept of a need for a "tidy appearance" by first grade.

Cleft Lip↗
PubMed1985

Isolated naso-ocular cleft: a one-stage repair.

The naso-ocular cleft is a rare defect; however, isolated alar clefts with or without additional hamartomatous local tissue are an even rarer problem. The authors describe six unilateral and one bilateral cleft patients who were all initially repaired using the same operative procedure. The concept of this procedure is based on the principle that there is basically no soft-tissue deficiency but rather a malpositioning of the parts. The leading edge of the ala is re-created by a rotation advancement of both the medial and the lateral segments adjacent to the cleft. The created secondary defect is filled with a paranasal transposition flap. Three of our patients had hamartomatous excesses and were the most difficult to balance, and at the same time, two of these patients required subsequent bridging or augmentation using a free conchal cartilage graft. Examples of the operative procedures are outlined both schematically and clinically.

Humans↗
PubMed1979

The Cyrano nose: a clinical review of hemangiomas of the nasal tip.

It is always difficult to establish one preferred management program for all patients with any lesion, but serious consideration must be given to "no-touch" management of cavernous or capillary-cavernous hemangiomas of the nasal tip. This requires frequent consultations with the parents to furnish psychological support. If extreme pressure from the parents makes surgery inevitable, the operation should be limited to the immediate confines of the nasal tip.

Adolescent↗
PubMed1978

Ophthalmic sequelae of infantile hemangiomas of the eyelids and orbit.

The major findings in a study of 51 infants and children with infantile hemangioma of the eyelid were as follows: Visual complications occurred in 27 patients. The most common complications were amblyopia (in 22) and strabismus (in 17). Amblyopia of 6/60 (20/200) or less was probably caused by stimulus-deprivation, but amblyopia in the range of 6/30 (20/100) to 6/12 (20/40) was likely caused by anisometropia or strabismus. Eyelid occlusion of six months or more invariably resulted in amblyopia of 6/60 (20/200) or less. Occlusion for even one month carried a risk of amblyopia. Each child must be considered individually for therapy, which must be started as early as possible. Patients should receive careful follow-up from the beginning to prevent severe amblyopia. For difficult cases, we need more efficacious, safe methods to induce regression of these tumors.

Adolescent↗