Prophylaxis for patients with artificial joints?
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Biomedical subjects
Publications and source records attributed to L Snape.
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The Le Fort I osteotomy is a relatively simple procedure, commonly performed by oral and maxillofacial surgeons, with little morbidity. For pathological conditions of the nasopharynx, cranio-cervical junction and base of skull, the procedure provides good visualization to otherwise awkward anatomical areas. Nine such operations have been performed together with ear, nose and throat surgeons and neurosurgeons for various lesions. Particular reference is made to one case which illustrates the reliability and versatility of the approach, especially when combined with a midline palatal split.
A case of meningioma situated at the anterior rim of the foramen magnum with successful removal via a transoral approach is reported. A new technique of preventing cerebrospinal fluid leakage is described utilizing fascia lata and a bone baffle without any attempt to close the dura, either by primary suture or tissue sealants.
A case is described of a traumatic aneurysm of the superficial temporal artery and the differential diagnosis is discussed.
Thirty-two Hickman central venous catheters were placed in patients suffering mainly from blood disorders. The catheters remained in situ for an average of 64 days. In 20 patients the catheters were removed either because they were no longer needed (14) or at death (6). In five patients they are still in position. Complications in seven patients led to the catheter being removed and these included four patients with catheter related sepsis. The use of these catheters allows safe long-term access to the venous circulation even in the neutropenic, immunosuppressed patient.
A retrospective study of 262 patients with malignancy in the head and neck was undertaken. 15.6 percent of these patients presented with a metastatic gland in the neck as the only symptom. Forty-four percent of the nasopharyngeal tumours presented solely with a metastatic cervical node; as did 26 percent of hypopharyngeal tumours and 24 percent of tumours of the oropharynx. The problem of a patient presenting with a suspected malignant cervical gland as the only symptom is one which demands careful evaluation.
Seven patients are presented each with symptomatic malignant melanoma metastases to the alimentary tract. Where practicable, surgical excision of the metastases is justified because two patients have had worthwhile periods of survival.