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Biomedical subjects

J C Beirne

Publications and source records attributed to J C Beirne.

18 recordsLinked to original sources
PubMed2000

Radionuclide bone imaging for detection of mandibular invasion by squamous cell carcinoma.

The assessment of mandibular invasion is an important part of the pre-operative staging of oropharyngeal squamous cell carcinoma. When bone is surgically resected, histology often shows no direct bone invasion, yet such resections are associated with post-operative complication and morbidity. This prospective study of a large group of patients aims to lay down criteria for bone invasion using radionuclide bone imaging and orthopantomography, and to test their effectiveness when compared with histological analysis. 77 patients with proven squamous cell carcinoma of the oral cavity were investigated pre-operatively by radionuclide bone imaging and orthopantomography. All had bone resected as part of complete resection of the tumour. One patient had systemic bone metastases and was, therefore, excluded. In the remaining 76 patients, there were four false positive assessments for bone invasion radiologically and no false negatives. There were 48 true positive results and 24 true negatives, giving a sensitivity of 100% and specificity of 86%. It is concluded that correct application of the outlined criteria for bone invasion demonstrated that radionuclide bone imaging and orthopantomography are a sensitive test for bone invasion, with an acceptable level of specificity.

Adult↗
PubMed1997

An intra-operative technical aid to miniplating of mandibular fractures by fracture segment apposition.

Internal plate osteosynthesis and lag-screw osteosynthesis are currently the preferred methods of fixation in the treatment of mandibular fractures. Rigid internal fixation (RIF) provides for functionally stable immobilization of the segments, avoiding the need for postoperative intermaxillary fixation (IMF) by "dental wiring" in the majority of cases. Reduction and fixation can be provided by so-called compression plates (type AO/ASIF). Non compressive mini-plates are more extensively used, however, because their size and malleability facilitate their transoral application. Peroperative problems may arise with the anatomical reduction of the fragments. We present a simple fracture reduction-compression technique that can be used in combination with either compression and non-compression mini-plate fixation. Its use can be extended to reduction and fixation in selected areas of difficult surgical access.

Bone Plates↗
PubMed1996

Donor site morbidity of the anterior iliac crest following cancellous bone harvest.

Anterior iliac crest donor site morbidity was analysed retrospectively at 154 sites in 137 patients who had undergone secondary bone grafting of the cleft alveolus. The applied surgical anatomy and operative technique utilizing a medially based osteoplastic flap are described. The results show a low incidence of donor site morbidity.

Adolescent↗
PubMed1996

Use of fibrin glue in lower blepharoplasties.

This prospective study investigates the long-term appearance of the scar following closure of lower blepharoplasty incisions with the fibrin adhesive Tissucol compared with the usual subciliary suturing. Eighteen eyelids closed with fibrin adhesive were compared with 12 eyelids where a 5-0 running suture was used for closure and to 10 eyelids that did not undergo surgery. The measurement team consisted of a panel, blind to patients and technique, that scored the scar morphology on a scale of 1-4. The Dunn test showed no difference between the group treated with the tissue adhesive and the group with conventional subciliary closure. There was a difference between the Tissucol treated group and the control group (P < 0.01). The surgical technique and the advantages in lower lid incision closure are discussed.

Adipose Tissue↗
PubMed1996

A clinician friendly computerised head and neck oncology audit: the first year results.

Surgical audit is only as good as the information recorded and data entry is often onerous and the domain of the enthusiastic clinician or research follow. A head and neck oncology audit which incorporates a specific software program has been established in our department. The software interface increases the user friendliness of two conventional database systems, ACCESS and SUPERBASE and structures data input for the clinical situation. The program has been designed for ease of use by every clinician irrespective of their computer competence. The departmental prospective audit has been active since January 1993 and the essential details on new patient presentation, assessment, surgery and outcome for the first year are included in this article.

Aged↗
PubMed1995

Traumatic aneurysm of the maxillary artery: the role of interventional radiology. A report of two cases.

Two cases of post-traumatic aneurysm of the maxillary artery are described. The first patient was a 20-year-old man who sustained a Le Fort III type fracture in a road traffic accident. He experienced two episodes of significant maxillofacial haemorrhage, the first following admission and the second 5 days after initial reduction and fixation of his midfacial fractures. The second patient was a 23-year-old man with a bilateral cleft palate and extreme midfacial hypoplasia who underwent Le Fort I osteotomy. Significant bleeding commenced 3 h postoperatively and was not completely controlled by anterior and posterior nasal packing. Both the aneurysms were diagnosed on selective carotid angiography and successfully treated by embolization.

Adult↗
PubMed1995

Cervical spine injuries in patients with facial fractures: a 1-year prospective study.

A total of 582 consecutive patients with facial fractures were investigated prospectively for evidence of a concomitant cervical spine injury. Of them, 1.04% (6) were found to have a cervical spine injury, all having occurred in road traffic accidents. Only two of the injuries were diagnosable on standard, three-view, plain cervical spine radiographs. Four were diagnosable from computerized tomography scan, while the remaining two required stress views under radiographic screening for definitive diagnosis.

Accidents, Traffic↗
PubMed1995

Correlation of histopathologic findings with clinical and radiologic assessments of cervical lymph-node metastases in oral cancer.

The accuracy of preoperative diagnosis of cervical lymph-node metastasis in oral cancer was assessed by comparing the histopathologic findings in 136 sides of neck dissection with physical examination under anaesthesia (EUA) and computerized tomography (CT) assessments of the metastatic status. The overall accuracy of EUA and CT assessments was 72% and 73%, respectively, and a combination of both methods resulted in sensitivity and specificity rates of 55% and 78%, respectively. Twenty-three of the 51 histologically positive necks had been assessed as negative on both EUA and CT. Six of these contained only micro-metastases, and in another 10, the largest positive node was 1.5 cm or less. Extracapsular spread of metastatic carcinoma was found in 12 of the 23 EUA and CT false-negative dissections. Most of the 21 histologically positive necks which had been correctly assessed as positive on both EUA and CT contained enlarged metastatic nodes, fused nodal masses, extensive extracapsular spread, or more than one of these features. Three of the 85 histologically negative necks had been assessed as positive on both EUA and CT; eight had been positive on EUA alone, and another eight on CT alone. Reactive nodal hyperplasia or sialadenitis was seen in most false-positive dissections. We conclude that the accuracy of preoperative diagnosis of metastasis by routine methods remains poor, and that EUA and CT are reliable only in patients with bulky metastatic deposits.

Adolescent↗
PubMed1995

Myositis ossificans traumatica of sternocleidomastoid muscle presenting as cervical lymph-node metastasis.

It is well known that clinical assessment of the metastatic status of the cervical lymph nodes in patients with squamous cell carcinoma of the upper aerodigestive tract is frequently inaccurate, and several causes for false-positive assessments are well described. We report a novel cause, namely, a case of myositis ossificans traumatica of the sternocleidomastoid muscle, which presented as a neck mass after a direct laryngoscopy for biopsy of a laryngeal squamous cell carcinoma. The importance of this lesion is that it should be considered in the clinical differential diagnosis of swellings in the neck.

Aged↗