The hidden costs of malpractice.
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Biomedical subjects
Publications and source records attributed to L M Davey.
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An unusual case of neurofibrosarcoma of the cranio-orbital-maxillary region was resected by a combined neurosurgical and plastic surgical team. The resulting defect was reconstructed in one stage with a free rectus abdominis myocutaneous flap, obviating the need for subsequent prosthetic obturation of the maxillary defect. This reconstructive technique expedited the patient's convalescent period, allowing him to return to work 3 weeks following surgery. Wound healing was uneventful, and the cosmetic result was acceptable to the patient.
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Decompression of the perioptic meninges for intractable chronic papilledema was done in a patient with a right parietal temporal glioblastoma multiforme. The patient died 39 days postoperatively. Histologic study of the optic nerves indicated fistulas in the dura compatible with cerebrospinal fluid (CSF) egress and maintenance of a normal subarachnoid space around the nerve. Two additional patients with unilateral optic nerve decompression producing bilateral resolution of papilledema were studied. We contend that egress of CSF was the principle mode of action in these three cases. How long the dural fistula remains patent is unknown. Reports in the literature show considerable variation in the effects of optic nerve decompression. Anatomic variation of the intracanalicular subarachnoid space together with differences in underlying pathologic condition, surgical technique, and patient response may explain discrepancies among the results reported.
A case is presented with the acute development of a pineal region syndrome secondary to hemorrhage into a pineal cyst in a patient who was under anticoagulant therapy. Resolution of the symptoms and signs followed excision of the lesion.
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A brief illustrated atlas demonstrates the progressive relationships of the anatomical structures of the cat's middle ear as one dissects these from the attic approach. There was an attempt to demonstrate the nerves of the lateral semicircular canal and the utricle but without preserving the footplate of the stapes to afford an unobstructed view of the nerves. For the first time, the anatomical features of the cat's middle are are brought together in a progressively illustrated and single source.