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Biomedical subjects

J K Pitcock

Publications and source records attributed to J K Pitcock.

6 recordsLinked to original sources

Does intralaryngeal motor nerve sprouting occur following unilateral recurrent laryngeal nerve paralysis?

Reinnervation of paralyzed intralaryngeal muscles by axonal sprouting from adjacent intact muscles (the phenomenon of muscular neurotization) has been observed, but the source is uncertain. The potential for laryngeal reinnervation of the posterior cricoarytenoid muscle (PCA) from contralateral PCA motor nerve sprouting in a rabbit model was investigated. Unilateral PCA denervation was produced by vagotomy. The rabbits were examined for signs of PCA recovery for up to 6 months, using fiberoptic endoscopy, electromyography (EMG), and histology. No return of vocal cord abduction, EMG activity, or any nerve sprouting across the midline from the intact PCA was found. We conclude that there is no significant spontaneous intralaryngeal muscular neurotization to the paralyzed PCA. The clinical ramifications of our data will be discussed.

Animals↗

The transfacial approach for combined anterior craniofacial tumor ablation.

The transfacial approach to the anterior cranial fossa for tumor removal provides for excellent surgical exposure, improved postoperative appearance, and a minimum of complications. The technique is different from previously reported combined craniofacial ablative procedures in that the head and neck surgeon and the neurosurgeon approach the anterior fossa mass through the same facial incision, thus avoiding the need for a separate craniotomy incision. The formation of a vascularized nasofrontal bone flap allows for better wound healing regardless of preoperative and postoperative radiotherapy and/or chemotherapy. This report presents 42 cases in which the transfacial approach was exclusively used in a combined manner to remove nasal, paranasal sinus, and nasopharyngeal neoplasms. The transfacial technique offers a significant advantage over previously described approaches to the anterior skull base.

Facial Bones↗

Free omental flap reconstruction of complicated head and neck wounds.

Complicated wounds of the head and neck involve a severe deficiency of tissue in a contaminated or irradiated area that is predisposed to infection and necrosis. Reconstruction of these wound areas frequently requires multiple operations and prolonged hospitalization. We have successfully reconstructed complicated head and neck wounds in thirteen patients by means of a single-stage microvascular tissue transfer of the greater omentum with or without an attached segment of the stomach wall. There were 11 complete successes, two partial failures, and no complete failures. We describe four cases to illustrate the basic fundamentals of this reconstructive technique.

Adult↗

Burkitt's lymphoma.

Cancer is the second leading cause of death in children and, among cancers, lymphoma is the third most frequently diagnosed type. The majority of these are non-Hodgkin's lymphomas (NHL). Although NHL have been grouped in a variety of confusing ways, recent research in cytogenetics and immunology, coupled with a better understanding of the normal pathways of lymphoid differentiation, has greatly lessened this confusion. Burkitt's lymphoma (BL) is a type of B-cell NHL which is sub-classified as either endemic (African) or non-endemic (American). Kinetic studies have demonstrated a doubling time of only 24 h. As a result of this extremely rapid growth, symptomatic complaints occur early in the disease course. Structures contiguous to the primary become compressed and metabolic derangements occur. Signs of chronic debilitation such as cachexia, diarrhea, generalized lymphadenopathy, and weight loss usually are not found. Thirteen cases of American BL have been treated since 1980 at the Texas Children's Hospital and form the basis of this review. Ten patients had obstructive abdominal symptoms including constipation and pain, and 3 had masses in the neck, maxilla, or tonsil. Systemic manifestations included ascites, jaundice, fever, and hepatosplenomegaly. Two patients ultimately developed central facial nerve paralysis.

Abdominal Neoplasms↗

Tuberculous petrous apicitis.

Tuberculous osteomyelitis of the temporal bone is a rare and dangerous entity that should be included in the differential diagnoses of infectious processes of the base of skull. A 21-year-old man presented with petrous apicitis, extradural and retromandibular abscesses, and paresis of the facial nerve. Immediate middle fossa craniotomy and drainage of the extradural abscess, in combination with a mastoidectomy, incision and drainage of the facial abscess, and antimicrobial therapy for gram-positive cocci, failed to check the destructive nature of the infection. The patient subsequently developed labyrinthitis, sensorineural hearing loss, and meningitis. Intraoperative biopsy specimens confirmed the presence of tuberculoid granulomas, and the infectious process responded to triple-drug therapy. Tuberculosis of the temporal bone should not always be considered an indolent infection. The management of tuberculous infection of the temporal bone is outlined.

Adult↗

Laryngeal atresia: a detailed histologic study.

Laryngeal atresia is a rare, life-threatening anomaly. A case is reported with histological analysis of the deformity. Although there are different theories of glottic development, all authors agree that the primitive glottis is occluded at one time by an epithelial plug. Laryngeal atresia is felt to represent a lack of recanalization of the embryonic larynx. Laryngeal embryology is reviewed and the various types of laryngeal atresia are compared to the stages of laryngeal development.

Humans↗