Biomedical subjects
Publications and source records attributed to J W Canady.
Nasal obstruction is commonly due to septal deviation, enlarged turbinate mucosa, enlarged bony turbinates, nasal valving or, occasionally, a ptotic nasal tip. Correct preoperative diagnosis using the algorithm presented will lead to the appropriate selection of treatment for the patient groups discussed. The same diagnostic system will help the surgeon avoid patients who are likely not to be helped by operative intervention.
Cleft lip and palate defects assume many forms from mild to severe, but all may be associated with abnormal craniofacial development. Even the most expert and sophisticated methods of surgical repair are followed by scar contraction and fibrosis, which result in skeletal defects, dental abnormalities, cosmetic disfigurement, and speech impairment. Recent clinical and experimental observations that fetal cutaneous wounds heal without scarring are of great potential interest in the management of cleft lip and palate. The objective of this study was to investigate the effect of prenatal repair of iatrogenically produced cleft palate on scar formation in the fetal lamb model. Ten ewes were operated on ranging in gestation from 70 to 133 days. Fifteen lambs were studied (nine cleft palates produced and repaired in utero; one cleft produced in utero and not repaired, four normal, unoperated palates; and one cleft palate produced and repaired 1 week postnatally). The lambs were delivered normally at 145 to 147 days gestation and maintained with the ewe until 1 month of age. The lambs were euthanized, and the surgical area of the palates studied grossly and histologically. Animals operated at 112 days or later in gestation exhibited scars both clinically and histologically. The animals that had cleft palate produced and repaired at 70 days gestation did not have a visible palatal scar at 1 month of age. Histologically, there was evidence of minimal scarring without disruption of normal architecture. Studies are underway to determine the impact of reduced scarring on craniofacial growth after palatal repair during mid gestation in the ovine model.
1. It is generally assumed that oral blood flow is higher than that of skin, and invasive methods to measure blood flow support this view. 2. However, it was not known whether this finding would be confirmed by laser Doppler flowmetry, which is a noninvasive method to measure blood flow. 3. The purpose of this study was to compare blood flow in oral and skin regions of the rhesus monkey using laser Doppler flowmetry. 4. The results demonstrated that blood flow was significantly higher in oral regions as compared to facial skin (P < 0.05). 5. This finding is most likely related to the more abundant capillary supply in oral mucosa as compared to skin.
Many donor sites have been advocated for obtaining cancellous bone to be used for grafting alveolar defects. Recently, some authors have suggested that the iliac crest site produced an unacceptably high degree of postoperative morbidity. Because of this morbidity, the use of other donor areas, e.g., rib, cranium, and mandible, are advocated. The iliac crest donor site for alveolar bone grafting has been common practice in our institution for years under the assumption that little or no postoperative morbidity occurred. To investigate and document the accuracy of our assumption, the charts of the most recent 50 consecutive patients receiving alveolar bone grafts, all of which used the iliac crest as a donor site, were reviewed. Postoperative pain, numbness, infection, paralysis, or long-term disability were catalogued from the charts. In addition, a questionnaire was sent to the parents and patients requesting their perceptions of these parameters. In the cases reviewed, the average length of skin incision was 4.2 cm. The average quantity of bone harvested was 4.1 cc. The usual hospitalization time was 2-3 days. No patients experienced serious or long-term complications at the surgical donor site. Immediate postoperative complications among the 50 patients studied were limited to one hematoma, one stitch abscess, one case of swelling with pain, one erythema, and one 4-day fever accompanied by slight serosanguineous drainage. Information from the questionnaire suggests that most patients returned to full activity within 4-6 weeks. No patient reported any long-term pain or disability.(ABSTRACT TRUNCATED AT 250 WORDS)
Magnetic resonance imaging is frequently used for visualization of soft tissues of the head and neck. It was the purpose of this study to determine whether gold eyelid weights, used for treatment of lagophthalmos in facial palsy, would be deflected at high magnetic strengths during imaging. Ex vivo study of six incrementally increasing weights at two magnetic strengths was performed. There was no deflection of any of the gold eyelid loads at either 0.5-tesla or 1.5-tesla magnetic strengths. We conclude that patients with gold eyelid weights are not at risk of damage from movement of the prostheses during magnetic resonance imaging examination.
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The present study investigates blood flow at several stages of expansion with and without enhancement by anticontractile agents (papaverine). Twelve 1-kg guinea pigs were divided into two groups. In group 1 were six animals undergoing tissue expansion without anticontractile agents, and in group 2 were six animals treated with a saturated solution of papaverine prior to expansion. Laser-Doppler velocimetry was used to monitor the changes in blood perfusion that occurred with each expansion. Animals pretreated with papaverine (group 2) maintained higher blood flow following inflation of the expander than untreated animals (group 1). This study provides physiologic evidence of the benefits of pharmacologic enhancement of the expansion process. Agents of this type may have a future role in the prevention of ischemic complications.
This study provides additional information about changes in blood flow in expanded tissue as measured by laser Doppler. Five one-kilogram albino Hartley guinea pigs were implanted with commercially available hemispheric expanders. The expanders were inflated every 3 days on four successive occasions. Blood flow measurements were taken on each animal just before each inflation, immediately after inflation, and then at 1, 2, 3, 4, and 24 hours after expansion. Measurement of flow changes immediately after each inflation of the expander showed that, initially, blood flow in the tissue overlying the expander recovered quickly, but as the expansion process was continued, the flow did not return to baseline values so rapidly. This might be an indication that tissue expansion in patients could be carried out more rapidly during the initial inflations, with increasing recovery periods between inflations as the expansion process continued.
High-pressure petroleum injection injuries and best known in the distal part of the upper extremity. A recent Medlars search revealed several articles dealing with this type of injury in the hands and wrists, but, as yet, there have been no publications of this type of trauma to the head and neck region. A 35-year-old farmer sustained a high-pressure petroleum injection injury to the lower part of the left cheek and neck. This case might serve as a guide for management of similar cases in the future.