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Biomedical subjects

Oren Friedman

Publications and source records attributed to Oren Friedman.

11 recordsLinked to original sources
PubMed2006

Facelift surgery.

The demand for aging face surgery has increased dramatically over the past few decades, and it is likely that it will continue to flourish as the segment of our population over 65 years of age continues to grow. Facelift surgery is the cornerstone of aging face surgery. It is a procedure that has evolved over the years and has been designed to restore a youthful look to the lower face and neck. There are several different approaches available for the management of the aging face, each of which may be best suited to certain patient characteristics. It is essential that all approaches be understood to provide the most aesthetically pleasing surgical results to every patient.

Aged↗
PubMed2006

Facial liposculpture.

Modern advances in rejuvenation of the aging face have minimized morbidity and recovery time and maximized natural aesthetic results. Liposuction and autologous fat transfer techniques have emerged as popular methods to achieve these ends. Used alone, or in conjunction with other modalities, lipocontouring will likely continue to play a prominent role in facial aesthetic and reconstructive surgery.

Adipocytes↗
PubMed2005

Changes associated with the aging face.

The demand for facial plastic surgery has increased dramatically in recent years as persons from all socioeconomic levels and age groups have become interested in facial rejuvenation. As the population ages, the demand for esthetic surgery in the elderly will increase at an even greater rate. Before the surgeon begins to learn specific techniques in facial plastic surgery, he or she should have a thorough understanding of the anatomy of the aging face. Safe and effective esthetic surgery is possible only when the anatomic changes associated with the aging face are appreciated by the surgeon and patient.

Aging↗
PubMed2004

The effect on snoring of structural nasal valve dilatation with a butterfly graft.

OBJECTIVE: To evaluate the effect on snoring of structural nasal valve dilatation with butterfly spreader grafts in patients with nasal valve insufficiency. DESIGN: Retrospective medical chart review and telephone follow-up; mean +/- SD follow-up time, 20.7 +/- 11.34 months (range, 3-48 months). SETTINGS: Tertiary care referral center. SUBJECTS: A total of 37 snoring patients with nasal valve insufficiency who underwent nasal valve dilatation with a butterfly spreader graft. INTERVENTIONS: The conchal cartilage butterfly graft technique was performed during rhinoplasty through either an external or endonasal approach. MAIN OUTCOME MEASURE: To establish through a retrospective review that butterfly graft conchal cartilage nasal reconstruction is effective in reducing snoring. RESULTS: After surgery, 30 patients (81%) had significant improvement in breathing, 5 (14%) had slight improvement, and 2 (5%) had no benefit in breathing. Snoring stopped completely in 11 (30%) of the patients after surgery. The improvement in snoring was significant in 13 patients (35%) and slight in 3 (8%). Twenty-six patients (70%) reported tiredness and grogginess on awakening before the surgery. Surgery significantly improved patients' tiredness and grogginess on awakening in 15 cases (58%), slightly improved them in 5 (19%), and did not change the patients' tiredness and grogginess in 6 cases (23%). CONCLUSION: The conchal cartilage butterfly graft yields successful results not only in breathing but also in snoring symptoms in patients with nasal valve insufficiency.

Adult↗
PubMed2004

Anatomy of the thyroarytenoid branch of the recurrent laryngeal nerve.

OBJECTIVE: To determine the position and anatomic variability of the thyroarytenoid (TA) branch of the recurrent laryngeal nerve (RLN). METHODS: The RLN on 13 human cadaver specimens (24 sides) was dissected to the termination of the TA branch in the TA muscle. A pin was placed at the inferior aspect of the thyroid cartilage at the inferior tubercle. Using a caliper, the distance from the pin to the TA branch of the RLN was measured. The direction of the nerve and number of branches were recorded. RESULTS: The average distance to the TA branch of the RLN is 4.23 mm with a standard deviation of 2.86 mm. The median distance is 3.75 mm. Most of the specimens fell in a range of 1 to 4 mm. Overall, 54% of the nerves traveled in a horizontal direction, but vertical and oblique orientations were observed. About 20% of specimens demonstrated branching of the TA nerve. CONCLUSION: Measuring 4 mm from the inferior tubercle along a perpendicular line from the thyroid tubercle on the inferior border of the thyroid cartilage provides a good estimate of the location of the TA branch of the RLN. This information is useful when creating a posterior thyrotomy for TA neurectomy for patients with adductor spasmodic dysphonia. Knowledge of the course and possible branching of the nerve, will aid in localizing the nerve as well as ensuring adequate resection.

Cadaver↗
PubMed2003

Amyloidosis of the upper aerodigestive tract.

OBJECTIVES/HYPOTHESIS: To delineate the clinical and pathologic characteristics of upper aerodigestive tract amyloidosis with particular attention to laryngeal amyloidosis. STUDY DESIGN: Retrospective chart review of patients with amyloidosis of Thomas Jefferson University and its affiliated hospitals. MATERIAL AND METHODS: The charts of 16 patients with upper aerodigestive tract amyloidosis identified from the databases of the Thomas Jefferson University pathology department were reviewed and included in the study. RESULTS: Sixteen patients (9 male and 7 female, with an average age of 49.8 years) with upper aerodigestive tract amyloidosis were identified. The most common site of amyloid involvement was the larynx. Consequently, patients most commonly presented with hoarseness (14 of 16). All patients underwent surgical removal of the amyloid deposits. Fourteen patients had primary localized amyloidosis. Two experienced systemic involvement. Seven of the 16 patients developed recurrences requiring further treatment. CONCLUSIONS: Amyloidosis of the upper aerodigestive tract generally behaves as a benign, localized condition treatable by surgical resection. Regular follow-up with laryngoscopy is indicated for early diagnosis of recurrence, and multiple surgical procedures may be required to control symptoms.

Adult↗
PubMed2002

The feasibility of office-based laser-assisted tympanic membrane fenestration with tympanostomy tube insertion: the duPont Hospital experience.

OBJECTIVE: To determine the feasibility of inserting tympanostomy tubes in children using office-based laser-assisted tympanic membrane fenestration. METHODS AND MATERIALS: Study consisted of a retrospective review of the charts of all children who underwent office-based laser-assisted tympanic membrane fenestration with tympanostomy tube insertion from July 1, 1998 to August 31, 2000. Tetracaine eardrops were used for topical anesthesia. Fenestration was achieved with the OtoLAM flashscanner laser (ESC Sharplan, Yokneam, Israel). RESULTS: Of the 127 patients (185 ears) who underwent laser-assisted tympanic membrane fenestration, 61 ears underwent tympanostomy tube insertion. Ten ears were treated for otitis media with effusion, 43 for recurrent acute otitis media, and eight for acute otitis media not responding to antibiotics. Fifteen ears had purulent effusion, five had a serous effusion, and 23 had mucoid middle ear fluid. Eighteen ears had no middle ear fluid. At the first follow-up visit, all tested ears had hearing of 20 dB or better. Two children had tubes that were blocked. Blockage occurred in ears that required more than one laser firing to penetrate the tympanic membrane. Otorrhea was present in 13 ears (21%). Otorrhea occurred exclusively in ears with purulent or mucoid middle ear fluid. CONCLUSIONS: Office-based laser-assisted tympanic membrane fenestration with tympanostomy tube insertion is a safe and effective alternative to tube placement in the operating room. The outcome compares favorably with previously published data.

Ambulatory Surgical Procedures↗
PubMed2002

Temporal bone hemangiomas involving the facial nerve.

OBJECTIVE: Hemangiomas of the facial nerve are rare tumors that can mimic more common temporal bone tumors such as vestibular schwannomas and facial nerve schwannomas. This article reviews the diagnostic challenges in the surgical treatment of facial nerve hemangiomas. STUDY DESIGN: Two case reports and literature review. RESULTS: Early diagnosis and surgical excision of facial nerve hemangiomas can sometimes allow tumor removal with facial nerve preservation. In patients in whom the facial nerve needs to be resected to remove the hemangioma, primary anastomosis or cable nerve grafting can yield House-Brackmann Grade III/VI postoperative facial nerve function. CONCLUSION: Complete surgical excision of facial nerve hemangiomas with primary facial nerve repair (when necessary) is the treatment of choice for these lesions.

Bone Neoplasms↗
PubMedDate not supplied

Reconstructive rhinoplasty: the 3-dimensional nasal tip.

OBJECTIVES: To review nasal alar support mechanisms, introduce the concept of tractional forces on the nasal ala, and describe a reconstructive technique to correct nasal tip deformities associated with weakened tractional force on the nasal ala. DESIGN: Photographic study and retrospective medical chart review. RESULTS: We noted that patients with weakened support at the dome of the lower lateral cartilage had lateral alar deformities. Strengthening the cartilaginous deficiency improved the nasal appearance and function in 90% of patients. CONCLUSIONS: Deformities of the nasal tip are among the most difficult to correct. Tractional forces provided by dome strength help to maintain the ala in its normal anatomical position. Structural tip grafts restore the tractional force and, thereby, help to correct the alar deformity.

Adult↗
PubMedDate not supplied

An alternative method of middle vault reconstruction.

Surgery of the nasal valves is a challenging aspect of rhinoplasty surgery. The middle nasal vault assumes an important role in certain aspects of nasal valve collapse. Techniques that address pathologies of the middle vault include the placement of spreader grafts and the butterfly graft. We present an alternative technique of middle vault reconstruction that allows simultaneous repair of nasal valve collapse and creation of a smooth dorsal profile. The surgical technique is described in detail and representative cases are discussed.

Cartilage↗