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Biomedical subjects

T D Cronin

Publications and source records attributed to T D Cronin.

At least 19 recordsLinked to original sources
PubMed1988

Correction of the unilateral cleft lip nose.

The cleft lip nasal deformity is best repaired secondarily in teenagers. Some more severe cases may be repaired during childhood. Optimal repair requires adequate exposure, best obtained with transcolumellar flying-bird incisions. The major anatomic defect, the misplaced lateral crus, needs to be advanced to a normal position. The vestibular lining of the lateral crus should remain attached to add circulation and support, especially when scoring of the cartilage is needed. The lateral defect left after advancement of the lateral crus should be closed with sutures. Accessory procedures, including septoplasty, augmentation or reshifting of the alar base attachment, and occasionally, cartilage grafts, are critical to achieving an aesthetic result. Fifty-three patients operated on using the technique described are reviewed.

Adolescent↗
PubMed1988

Change in nasal resonance over time: a clinical study.

Fifteen of the 20 patients who had been judged by a speech pathologist and two surgeons to have had poor resonance following surgical treatment were recalled in order to review factors that may have been related to this poor result. In the present study, the poor-resonance patients were reanalyzed for present status given that they had received no further surgical intervention. The results indicate that over one-half of those patients now have normal resonance; this gives the patients who were repaired by the Cronin technique an 89 percent probability of achieving normal resonance. The age of the patient at the time of evaluation appears to be an important factor. Patients judged as "poor-resonance results" were more likely to be less than 5 years of age, but as they matured, judgment of "resonance" indicated improvement.

Articulation Disorders↗
PubMed1985

The Cronin push-back palate repair with nasal mucosal flaps: a speech evaluation.

This is a retrospective study of 92 cleft palate patients who had been repaired with the Cronin push-back palate repair with nasal mucosal flaps. The patients were evaluated by a speech pathologist for intelligibility, articulation, and resonance and rated using a 5-point scale devised for this study. Readily intelligible speech was present in 78 percent. Normal articulation was present in 66 percent. Normal resonance was present in 78 percent of the total subject group. Secondary procedures were performed in 14 percent of the group. Repaired clefts of the soft palate achieved a high rate of normal intelligibility, articulation, and resonance. Repaired submucous clefts and short palates achieved the lowest percent of normal articulation and resonance. Educational placement, hearing, and type of structural deformity all appear to influence the ultimate communication outcome.

Child↗
PubMed1983

The V-Y rotational flap for nasal tip defects.

The V-Y rotational nasal flap is designed for repair of defects of 1 to 2.5 cm involving the lower third of the nose. The flap is rotationally-based on the side of the nose with a triangular extension into the glabellar area. It is done in one stage and in most cases gives an almost invisible scar with no depression or mismatch of color as with skin grafts. Seventeen such patients have been treated with this method since 1968.

Aged↗
PubMed1983

The Tennison Lip repair revisited.

Tennison presented his method for the repair of the single cleft. He was the first to recognize and to preserve the cupid's bow by lowering the peak in the margin of the cleft. He incised the medial side of the cleft and filled the space with a triangular flap from the lateral side. We have modified the Tennison repair based on the vertical height of the normal side, as did Randall and Hagerty. We make the lip 1 mm shorter in the vertical height than the normal side because some of our repairs were too long. Other modifications include a 1-mm offset at the vermilion, and in certain lips that are too long in the newborn, a triangle is excised beneath the alar base to shorten the vertical height. The details for planning the incisions and accomplishing the surgery are given. Certain patients required a V-to-Y procedure to augment a vermilion deficiency, but none of these patients required a secondary procedure. This emphasizes the need for careful planning to get it right at the primary repair. The operation is indicated for the incomplete cleft to the very wide cleft, and in no patient was a lip adhesion required. We no longer operate on the nose at the primary repair.

Adolescent↗
PubMed1980

Breast reconstruction following mastectomy.

The mutilating effect of surgery for cancer of the breast has left many women needful of reconstruction to restore the body contour and self-image. Reconstruction involves replacement of the three elements that have been lost: breast mass, skin, muscle and nipple-areolar complex. Methods for accomplishing this have been devised and are in common use. Because of the increased predisposition to malignancy in the remaining breast and the difficulty in achieving symmetry in both breasts, the remaining breast must be considered, with subcutaneous mastectomy being the most appropriate course in most cases. Patient acceptance has been excellent.

Breast↗
PubMed1979

Reconstruction of the breast without additional skin or muscle flaps.

After mastectomy (usually simple or modified radical) many breasts may be reconstructed without additional tissue. However, in any patient in whom the skin flaps are very thin and/or tight, especially if the flaps have been irradiated, we urge use of the thoracoepigastric flap, latissimus dorsi muscle, or myocutaneous flap to achieve a pleasing result.

Adult↗
PubMed1978

Lengthening of the short columella associated with bilateral cleft lip.

Operations for lengthening the columella can be classified into three groups on the basis of source of material: lip, nose, or ear. When seen in profile, the middle of the lip provides one-fourth to one-third of the forward projection of the columella as compared with the level of the alar bases. Complete bilateral cleft lips usually benefit from columellar lengthening, but symmetrical, incomplete clefts rarely require it. Ancillary procedures, such as correction of a retruded maxilla by Le Fort I osteotomy or by contour build-up, can enhance the overall result. Our experience with advancement of skin from the floor of the nose and ala [15], skin from the alar margins at the tip [7], prolabial advancement flaps, fork flaps, and composite earlobe grafts is reported.

Adolescent↗
PubMed1977

Reconstruction of the breast after mastectomy.

We have described our techniques for reconstruction of the breast after a simple mastectomy, a modified radical mastectomy, and a radical mastectomy. Inadequate skin cover must be relieved, preferably by transposition of a thoracoepigastric flap. Not only must a mound be created, but also a nipple-areola complex. The areola can be constructed by nipple-sharing techniques from the opposite breast or by the use of the labia minora and/or the labia majora. However, we advise preservation and banking of the nipple-areola (or areola) by the ablative surgeon, when possible. The remaining breast usually requires some modification to match the reconstructed one.

Breast↗