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Biomedical subjects

M L Cheney

Publications and source records attributed to M L Cheney.

At least 37 records · Page 2Linked to original sources
PubMed1996

The use of the temporoparietal fascial flap in temporal bone reconstruction.

After routine canal wall down mastoidectomy, local muscle flaps with and without bone paté, cartilage and fascia are the standard techniques available to otologists wishing to obliterate the mastoid and reconstruct the external auditory canal. Reconstructive options for temporal bone defects after extirpative surgery for cancer, osteoradionecrosis, and revision surgery for chronic granulomatous otitis media, however, are few. Although the neighboring temporoparietal fascia flap (TPFF), based on the superficial temporal vessels, has been frequently employed for auricular reconstruction, its versatility in temporal bone reconstruction has not been widely explored. The TPFF has recently been employed at our institution in 11 patients who presented with a variety of reconstructive problems, including defects after temporal bone resection, surgery for malignant otitis externa, and revision mastoid surgery. Follow-up in these patients ranged from 1 to 43 months (average 18.4 months) and surgical objectives of achieving a dry mastoid bowl, fully epithelialized canal, and/or reduction of mastoid cavity volume was attained in 100% of cases. The TPFF offers many advantages to the otologic surgeon when faced with reconstruction dilemmas that center around a poorly vascularized mastoid cavity and temporal bone. The TPFF is a reliable source of local well-vascularized tissue that is extremely pliable and facilitates both hearing and nonhearing preservation temporal bone reconstruction.

Adult↗
PubMed1995

The use of calvarial bone in nasal reconstruction.

OBJECTIVE: To demonstrate the utility of calvarial bone as a primary graft choice in nasal reconstruction. DESIGN: Case series. SETTING: Academic tertiary care center. PATTERN: Thirty-five consecutive patients who underwent split calvarial bone grafting to the nasal dorsum between June 1988 and September 1993 and who had post-operative follow-up. OUTCOME MEASURES: Serial clinical examination to assess volume loss, movement of the graft, and complications. Standardized photographs to assess nasal contour. RESULTS: Fixation of the graft was accomplished using a technique that promotes bone-to-bone healing without fixation screws or wires. The most common complication was seroma or hematoma of the scalp (8%). There were no dural tears or intracranial complications. Long-term donor site morbidity consisted of one case of local alopecia (2.8%). A good nasal contour was achieved in 97% of patients. CONCLUSION: Based on the experimental evidence reviewed and our clinical experience, split calvarial bone is recommended as a material of choice for nasal dorsal reconstruction.

Adult↗
PubMed1995

An anatomic study of the temporoparietal fascial flap.

OBJECTIVE: To clarify the neurovascular relationships in the temporoparietal fascial flap and to access its possible use as a sensate free of a pedicled flap. DESIGN: Anatomic dissections (gross) and examinations (histologic) were performed on 10 fresh cadaver heads. SETTING: Academic tertiary care facility, Boston, Mass. MAIN OUTCOME MEASURES: To determine the relationship of the sensory innervation (the auriculotemporal nerve) to the vascular supply (the superficial temporal artery) of the temporoparietal fascial flap, in addition to determining safe incisions and the level of flap elevation that will preserve the sensory supply to the flap. RESULTS: There is a consistent relationship of the auriculotemporal nerve to the superficial temporal artery allowing for auriculotemporal nerve preservation with standard flap elevation techniques and easy nerve identification in this cadaveric study. CONCLUSION: A clear understanding of the anatomic pattern allows for the potential creation of a sensate fascial flap or vascularized nerve graft that would add a potential additional dimension to this fascial flap.

Adipose Tissue↗
PubMed1995

Early temporalis muscle transposition for the management of facial paralysis.

Temporalis muscle transposition is a reliable surgical technique for the reanimation of patients with long-standing facial paralysis. It is often employed when facial nerve reinnervation via crossover or cable grafting is not possible. Temporalis muscle transposition can also be used for the immediate treatment of complete facial paralysis due to insults leaving the facial nerve anatomically intact but requiring a prolonged recovery time (more than 1 year). Because temporalis muscle transposition does not interfere with neuronal regeneration, it may be employed early in the management of complete facial paralysis when recovery is predicted to be extended and incomplete. The authors report their experience with early temporalis muscle transposition in the management of facial paralysis in 56 patients with an anatomically intact facial nerve. More than 90% of these patients achieved improved symmetry at rest as well as purposeful movement at the corner of the mouth. In the last 30 patients, the temporoparietal fascial flap was simultaneously harvested and successfully used to obliterate the donor site defect. In conjunction with the immediate implantation of a gold weight in the ipsilateral upper eyelid, this approach to the early management of facial paralysis helps reduce the period of facial disability from years to weeks in a select group of patients.

Adult↗
PubMed1995

MR imaging of neuronal transport in the guinea pig facial nerve: initial findings.

Certain dextran coated iron oxides such as MION (monocrystalline iron oxide nanocompound) coupled to wheat germ agglutinin (MION-WGA) have been shown to exhibit i) neuronal uptake ii) axonal transport and iii) strong magnetic effects on tissues (superparamagnetism) in which they are localized. In the current study, we utilized such an agent to visualize axonal transport in the facial nerve in vivo by magnetic resonance (MR) imaging. Following injection of the compound into the facial nerves of guinea pigs, MR images were obtained at multiple time points (1, 3 and 5 days) and the imaged tissues were processed for subsequent histological examination. In nerves that had been injected with MION-WGA, the entire nerve appeared as a uniformly hypointense structure with a calculated transport rate of 5 mm/day. By 3 days, the agent within the facial nerve was traceable by MRI from a site of injection in the buccal branch to the stylomastoid foramen. Fluorescence and autoradiography studies confirmed axonal transport. These results show that MION-based magnetopharmaceuticals can be used to demonstrate slow axonal transport, and thereby visualize functional peripheral nerves in vivo by MR imaging. The method holds promise for developmental neuroscience research as well as a method to detect neural abnormalities by MR imaging.

Animals↗
PubMed1995

Midforehead incision: an approach to the frontal sinus and upper face.

The coronal incision has established itself as the principal surgical approach to the forehead. It allows for a well-hidden scar and a wide field of surgical exposure. The midforehead incision, described in the brow-lift literature, is a cosmetically acceptable alternative to the coronal incision for patients with forehead wrinkles or who are at risk for male pattern baldness. In an analysis of 33 consecutive open frontal sinus procedures, we compared patients who underwent i coronal approach to a midforehead approach for operative time, blood loss, length of hospital stay, and cosmetic result. There was a trend toward decreased operative time and decreased blood loss with the midforehead approach. The cosmetic result was acceptable in all patients. We advocate the use of a midforehead approach to the frontal sinus in patients with deep forehead creases and with hairline recession and elderly or infirmed patients who cannot tolerate prolonged procedures or significant blood loss.

Esthetics↗
PubMed1993

The temporoparietal fascial flap in head and neck reconstruction.

The technique for using the temporoparietal fascial flap in head and neck reconstruction is described. The advantages and applications of this flap are discussed and illustrated with case reports. Donor site morbidity is discussed, and the details of flap harvesting are reviewed. We have found the flap to be useful in the reconstruction of a variety of defects that require thin, vascular, and durable coverage.

Adult↗
PubMed1993

Angiolymphoid hyperplasia with eosinophilia (histiocytoid hemangioma): evaluation of treatment options.

Angiolymphoid hyperplasia with eosinophilia is an uncommon benign vascular proliferative lesion of unknown cause. In this report, a case is presented of a patient who was confirmed to be positive for human immunodeficiency virus and in whom the lesion had shown rapid accelerated growth. The case is used to illustrate a variety of therapeutic techniques and to evaluate the effectiveness of the various alternatives in the treatment of this unusual clinical problem. Long-term follow-up after radical excision of the tumor mass is presented.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Chondroblastoma of the temporal bone. Case report and literature review.

Chondroblastoma is a rare tumor of bone that represents approximately 1% of all primary bone tumors. In the temporal bone, only 33 have been reported. We present a case of chondroblastoma of the temporal bone, followed by a literature review and analysis of reported cases. We conclude that the best chance for a prolonged disease-free interval is total excision using a combined otolaryngologic and neurosurgical approach.

Adolescent↗
PubMed1991

Leiomyosarcoma of the trachea. Case report.

Leiomyosarcoma of the trachea is a rare primary tumor of the upper airway. Twelve cases have been reported in the English-language literature. Our experience with a patient with leiomyosarcoma of the cervical trachea is presented. The classic symptoms, diagnosis, and surgical management of this case are contrasted with those of the previously reported cases. The surgical technique used for our patient, primary tumor resection with skin grafting and placement of a Montgomery Laryngeal Stent, is a unique and effective treatment.

Adult↗
PubMed1990

Heerfordt syndrome: a cause of facial paralysis.

Heerfordt syndrome is an unusual manifestation of systemic sarcoidosis and is characterized by parotitis, uveitis, and facial nerve paralysis. A case is presented and the clinical manifestations are discussed. Angiotensin converting enzyme assays along with tissue biopsy demonstrating noncaseating granulomas confirm the diagnosis.

Diagnosis, Differential↗
PubMed1989

Osteomyelitis of the frontal bone.

Osteomyelitis of the frontal bone and its complications remain a diagnostic and therapeutic challenge to the head and neck surgeon. This paper will deal with the etiology, pathogenesis, diagnosis, and treatment of osteomyelitis of the frontal bone, and its complications and sequelae. Special emphasis is placed on techniques for repair of forehead defects.

Acute Disease↗
PubMed1988

Isolated uvulitis secondary to marijuana use.

Isolated uvulitis is a rarely reported disease. Known etiologies include bacterial infection and trauma following the use of instrumentation in the airway. Three cases of isolated uvulitis secondary to heavy marijuana smoke inhalation are reported. Specific recommendations regarding diagnosis and treatment of this disorder are made.

Adolescent↗
PubMed1987

Blindness as a complication of rhinoplasty.

Blindness following elective cosmetic surgery can be a devastating complication, for the patient as well as the surgeon. A case of unilateral blindness secondary to central retinal artery occlusion following an open septorhinoplasty is presented. Possible causes of blindness following rhinoplasty and steps to prevent this complication are addressed.

Adult↗