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Biomedical subjects

J Conley

Publications and source records attributed to J Conley.

At least 37 records · Page 2Linked to original sources
PubMed1979

Sublabial approach to the nasal and nasopharyngeal cavities.

A sublabial transnasal degloving approach to the mid-face, nasal cavity, septum, paranasal sinuses, and nasopharynx is described. This approach provides adequate exposure and ample facility for management of tumors in these areas. The pterygomaxillary space and infratemporal fossa ard readily accessible for hemostasis and management of tumor extensions. Children, adolescents, and women with benign and low-grade malignant tumors of these areas are the ideal candidates for this procedure. Twenty-six patients have been managed in this fashion, with no major complication. The cosmetic results have been excellent. This approach to the mid-third of the face, nasal, paranasal, and nasopharyngeal cavities should receive more attention and use.

Adolescent↗
PubMed1979

Thread augmentation for facial rhytides.

Thread augmentation, a subsurface technique for correcting facial rhytides, is especially applicable to perioral wrinkles, melolabial furrows, and frown lines about the forehead. It is basically an augmentation technique which places a volume of well-tolerated, slowly absorbable or nonabsorbable sutures underneath the wrinkle. These threads produce augmentation by their volume and the mild local reaction of edema, lymphocytic infiltration, and fibrosis. This process gradually progresses to internal scar formation as the suture material is dissolved by slow hydrolysis in the presence of tissue fluid over a period of months; the nonabsorbable suture remains as a permanent implant. A high level of patient satisfaction with minimal complications has proved the value of this technique in over 100 cases.

Absorption↗
PubMed1979

Surgical approach to retromandibular parotid tumors.

Because of the anatomy of the deep lobe of the parotid and its restrictive boundaries, retromandibular tumors may be asymptomatic until reaching massive size. Removal by an intraoral approach may be not only disappointing but also disastrous, with disintegration of the tumor and generalized spillage in the wound. Our experience suggests that the best approach to any type of tumor in this region is through the upper lateral cervical tissues with consideration of a mandibular osteotomy if the tumor extends into the retropharynx or the nasopharynx. This review of 12 patients who required osteotomy describes a high success rate with minimal complications.

Adenoma, Pleomorphic↗
PubMed1979

Hypoglossal-facial nerve anastomosis for reinnervation of the paralyzed face.

The hypoglossal-facial nerve crossover is a valuable surgical procedure for the treatment of certain types of facial paralysis. It is most effective when used as an integral part of a primary ablative operation for the treatment of cancer in this region. In the treatment of long-standing facial paralysis, its application requires an intact peripheral facial nerve system and some functioning mimetic muscles with an obliterated proximal facial nerve segment. It is recognized that other procedures are available for repair in patients who meet essentially these same criteria. The disadvantages are minimal intraoral crippling, mass movements of the face and, in some instances, hypertonia of the face. The advantages are improved facial tone, protection of the eye, intentional facial movements controlled by the tongue, and movements associated with physiological functions of the tongue.

Adolescent↗
PubMed1979

Avoiding facial nerve injuries in rhytidectomy. Anatomical variations and pitfalls.

Injury to the facial nerve in rhytidectomy has been occurring in less than one percent of the cases, and a spontaneous return of function in more than 80 percent of these injuries has resulted within 6 months. With the introduction of the newer and more aggressive techniques of platysmal and subplatysmal flaps and SMAS dissections, the risk of injury to facial nerve branches is obviously increased. Though there has not yet been an increase in the facial nerve injuries reported, these techniques are still relatively recent additions to the face-lift operation-and usually they have been done by more experienced surgeons, taking more time and working under direct vision with a more careful dissection. More care is needed to prevent injuries. We discuss here the detailed anatomy of the muscular branches of the facial nerve, how to prevent injuries to them during rhytidectomy, and how to manage injuries when they do occur.

Face↗
PubMed1979

Facial rehabilitation: new potentials.

There is some clinical evidence to support the theory that in the immediate rehabilitation of the paralyzed face some regionalization and separate movement of the eye, lips, and cheek may be produced. This is not accomplished by specific fascicular connections. It is postulated that a combination of intracranial and extracranial connections, which have not been identified to date, contribute to this phenomenon.

Cerebellopontine Angle↗
PubMed1979

Regional muscle transposition for rehabilitation of the paralyzed face.

Masseter and temporalis muscle transpositions may be considered in cases of longstanding facial paralysis and in the congenital absence of the facial nerve or muscles. The basic advantage of this technique is the introduction of a large volume of living and dynamic muscle into the face. Additional advantages include simplicity, the support provided, enhancement of the possibility of myoneurotization, and no loss of other significant function. In many instances, facial movement improves for a period of approximately two years, and the long-range effect would suggest some degree of rehabilitation of the facial muscles. Our combined experience with over 100 muscle transpositions indicates the efficacy and success of this technique in selected patients.

Facial Muscles↗
PubMed1979

Facial nerve grafting: a thirty year retrospective review.

It is axiomatic that nerve grafting be considered as an integral part of every ablative or traumatic injury involving the extratemporal main trunk and branches of the facial nerve. Our experience with 170 autogenous grafts has established the efficacy of the technique and has proved the high regenerative and adaptive capacities of the facial nerve system.

Cervical Plexus↗
PubMed1978

Facial rehabilitation with temporal muscle. New concepts.

Facial rehabilitation, utilizing the transposed temporalis muscle, was performed. Three new innovations of this technique include: (1) The whole muscle is transposed into the face to accomplish augmentation, support, protection for the eye, and movement. (2) Following transposition of the temporalis muscle, its nerve supply is lysed at the foramen ovale. Nerve substitution by a free, autogenous graft from the proximal segment of the ipsilateral facial nerve or crossfacial sural nerve is accomplished. This technique substitutes the facial nerve axons and nuclei for the trigeminal nerve in this muscle and thus eliminates movement on mastication and facilitates the possibility for expression. (3) This muscle may be transposed with a portion of the temporal and parietal bones to add bony architecture to the cheek and orbit.

Facial Muscles↗
PubMed1978

The masseter muscle flap.

This little-used muscle flap has four significant applications in radical ablation about the palate, pharynx, and mesopharynx that include the ascending ramus of the mandible, a portion of the tongue and lateral neck, and in radical operations on the parotid gland causing a facial paralysis: 1. It assists in the rehabilitation of the act of swallowing when it is sutured to the lateral hyoid arch, thus elevating the thyrohyoid complex and reinforcing this portion of the upper lateral neck. 2. This flap may be transposed over the upper portion of the internal carotid artery to provide protection for this vital structure. 3. This flap may be transposed into the internal nasopharynx and then dressed with a free split thickness skin graft to close this wound and to augment the nasopharynx, with improvement in speec and swallowing. 4. In facial paralysis it can be used to restore facial movement around the oral commissure and melolabial folds, thus improving appearance in repose and animation.

Face↗
PubMed1977

Lipomas presenting as parotid tumors.

Eleven cases of lipoma in the parotid region have been reviewed. Nine tumors were found to be compressing the lateral surface of the parotid gland (periparotidlipoma). One lesion was totally surrounded by salivary tissue, and another involved both the superficial and the deep lobes of a parotid gland (intraparotid lipoma). The tail of the gland was involved most frequently (six patients). The tumors were predominantly right sided (eight cases). All patients were treated by surgical excision. Only one tumor has recurred and this has apparently been successfully treated by a reexcision.

Adult↗
PubMed1977

Melanoma of the head and neck.

A retrospective review from 1935 to 1962 of 772 melanomas involving the head and neck seen at the Pack Medical Foundation (PMF) is presented with the main emphasis of 660 cutaneous and mucosal melanomas. Clark's levels for pathologic invasion are presented and correlated to 289 cases with 19 percent in Level II and 81 percent deeply invasive at Level III, IV, and V. The face was the most commom location with the cheek alone accounting for 22.3 percent of all the cases. The male to female ratio was 1.5 to 1 with 76 percent of the cases being equally distributed among the fourth through the seventh decades. 55.9 percent were local disease, Stage I, with 33.5 percent, Stage II, and 10.6 percent, Stage III or distal disease. The five-year or greater absolute cure rate in positive nodal disease was 12.6 percent. Elective versus no elective neck dissection in Stage IA disease demonstrated a five-year or greater absolute cure rate of 55 percent as compared to 38.5 percent. Distal metastases occurred in 30 percent of cases with elective neck dissection but in 70 percent of those cases with therapeutic neck dissection. The absolute five-year or greater cure rate was able to be analyzed in 556 cases. The rate was 25.6 percent for the mucosal and cutaneous lesions combined; an 8 percent rate for mucosal alone and 27.8 percent for cutaneous melanoma. The five-year or greater absolute cure rate for those cases treated totally at PMF was 35.4 percent.

Female↗
PubMed1976

Malignancies of the ear.

Cancer of the ear is an uncommon occurrence and rarely diagnosed early it its development. Routine biopsy of all granulomatous and neoplastic diseases of the ear is essential to early diagnosis. Polytomography is an aid in documenting the extent of the disease in bone. The surgical anatomy of the region of the ear imposes special disadvantages upon any type of surgical technique employed and supervoltage irradiation given. Temporal bone resection and its modifications, combined with irradiation, enhance the cure rate in the advanced cases and add significantly to the local control of this disease. A review of 273 cases is presented.

Adenocarcinoma↗