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Biomedical subjects

J Conley

Publications and source records attributed to J Conley.

At least 55 records · Page 3Linked to original sources
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↗
PubMed1975

Prognosis of malignant tumors of the parotid gland with facial paralysis.

A parotid malignant tumor with spontaneous facial nerve involvement is a serious prognostic sign. Of 34 patients reported, 29 have been followed for at least five years. In this group, 20 are dead of disease (one at five years), one is dead of other causes (at seven years), one is living with disease, and seven are free of disease. Four of these seven cases have been followed for more than ten years, with two being free of disease for 12 years. Thus, it is not a hopeless situation, as some studies have shown, and not a contraindication to combined radical surgery and radiotherapy treatment for cure if not palliation.

Adenocarcinoma↗
PubMed1975

Modified nondelayed forehead flap.

The versatility and benefit of the forehead flap need not be lost when the external carotid artery system has been ligated. By basing the forehead flap laterally on the scalp, nourishment from the opposite external carotid artery gives the head and neck surgeon another advantage in reconstruction with nondelayed expedience. We report three cases of wide cheek ablative surgery, external carotid ligation, and utilization of the forehead flap. The occasions to use this modified nondelayed forehead flap are few, but it offers the same advantage without staging. It definitely can be used in any situation requiring a forehead flap when the external carotid artery system has been ligated.

Aged↗
PubMed1975

Regional skin flaps in partial laryngectomy.

The use of regional neck flaps for rehabilitation has permitted an extension of operations on the glottis. The resection may include both vocal cords, both ventricular bands, one arytenoid and slight subglottic extension in a one- or two-stage technique. The resultant voice is low pitched, soft and has limited range. The cure rate was 85 percent.

Humans↗