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Biomedical subjects

W H Friedman

Publications and source records attributed to W H Friedman.

At least 55 records · Page 3Linked to original sources
PubMed1981

Contralateral laryngoplasty after supraglottic laryngectomy with vertical extension.

Eight patients with supraglottic carcinoma extending onto an arytenoid or true vocal cord have undergone supraglottic laryngectomy with vertical extension including the resection of an arytenoid. In these patients, the contralateral superior thyroid cornua was used to reconstruct the resulting defect. In this technique, the thyroid cornua is mobilized and green-stick fractured across the posterior commissure, maintaining its blood supply by leaving the inferior and middle pharyngeal constrictor attached. This muscle-cartilage pedicle flap provides bulk for the posterior glottis and can be anchored anteriorly to form the framework for a new vocal cord. Hypopharyngeal and pyriform sinus mucosa is then mobilized to cover the newly reconstructed hemilarynx. This reconstruction has provided a competent glottis with a good vocal baffle in every patient in this series. Preservation of airway, voice, and laryngeal sphincter is comparable with that achieved after routine supraglottic laryngectomy without resection of an arytenoid. Using this technique, the surgeon can rely on a pedicle graft with surprising accessibility, bulk, and reach.

Aged↗
PubMed1981

Stylohamular dissection: a new method for en bloc reaction of malignancies of the infratemporal fossa.

This study is a description of the "stylohamular" dissection, a technique for the en bloc resection of the infratemporal fossa. The medial plane of this dissection extends from the styloid process to the hamulus of the pterygoid just lateral to the foramen lacerum, allowing the surgeon to spare the internal carotid artery. The foramen ovale and foramen spinosum are routinely exposed during this procedure. Medially, the pterygoid musculature serves as the margin of the cancer block. Posteriorly, the mastoid tip may be included in this resection. Anteriorly, the lateral pterygoid plate is resected making it the anterior vertical plane of the dissection. Laterally, skin and mandible are the block margins. In the last three years, this approach has been utilized in eight patients with advance malignancies involving the infratemporal fossa. The results are encouraging. Five patients have remained well and free of disease for a maximum of three years postoperatively. Two patients have had recurrence of their tumor from six months to one year postoperatively. Palliation in all patients was excellent. The literature on various infratemporal dissections and their results is reviewed.

Adult↗
PubMed1981

Staging of carcinoma of the larynx: comparative accuracy of ct and laryngography.

The accuracy and clinical usefulness of both computed tomography (CT) and laryngography were evaluated in 30 patients with carcinoma of the larynx. The radiologic results were correlated with the surgical and pathologic findings. The accuracy in determining tumor compartmental localization (supraglottic, glottic, or subglottic) was as follows: CT provided the correct diagnosis in 26 cases. There were three false negative and one false positive diagnoses. Laryngography provided the correct diagnosis in 19 cases. There were six false negative and six false positive diagnoses. In virtually all cases, CT provided information equivalent to or more accurate than laryngography. CT is recommended as the radiologic procedure of choice when additional diagnostic information is required to supplement the findings of laryngoscopy in determining the feasibility of conservation surgery.

Diagnostic Errors↗
PubMed1979

Ectropion after blepharoplasty. Experimental and clinical observations.

Ectropion, or eversion of the lower lid, is the most common serious complication of blepharoplasty. Although many factors can be related to the production of this phenomenon, excess tension on the suture line has been implicated as a causal factor in the past. Because of the lack of instrumentation for measuring suture line tensions during the performance of blepharoplasty, and the relative difficulty in identifying suitable animal models, there has been little investigation of excess suture line tension as a cause of ectropion. This study was designed to establish a technique for measuring suture line tension during the performance of blepharoplasty and evaluating the effects of excessive suture line tension in the experimental production of ectropion in the stump-tailed monkey. In both monkey and human eyelid excisions, suture line tension is evaluated with the use of a fine-balance dynamometer. Suture line tension is shown to be a measurable parameter, and the technique of measurement is described. Excessive suture line tension has been demonstrated in monkeys and humans to be a causal factor in the production of ectropion following eyelid excisions.

Animals↗
PubMed1979

Workshopping.

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Education, Nursing, Continuing↗
PubMed1978

Computer tomography of the larynx.

Evaluation of computed tomography of the normal larynx has been performed utilizing corresponding tomographic and anatomic planes. The transaxial, coronal, and sagittal planes have been evaluated. While all three planes have distinct potential diagnostic value, the transaxial plane offers a unique view of laryngeal structures not afforded by any other technique. It is hoped that diagnostic criteria developed in this study will prove applicable to the evaluation of clinical laryngeal disease.

Humans↗
PubMed1978

Evaluation of laryngeal cancer by computed tomography.

Six cases of laryngeal cancer have been examined by computed tomography. The findings were correlated with those obtained by laryngoscopy and in five cases by pathological examination of the surgical specimens. Computed tomography accurately delineated the extent of tumor involvement of the laryngeal and paralaryngeal soft tissues. The diagnosis of involvement of the laryngeal cartilages presents some problems, which are discussed.

Aged↗
PubMed1978

Group therapy in family medicine: part 1.

Group psychotherapy may often be the treatment of choice for patients whose somatic symptoms are a reflection of interpersonal difficulties which are not of sufficient magnitude to warrant referral to a mental health professional. This type of treatment can be offered in the context of family practice, with benefit to both patient and physician. The physician may function as co-therapist with a more experienced group leader; it is essential, also, that competent supervision be available. Such a group was established in a family practice center; it met for 20 weekly sessions. Patient improvement ranged from minimal to considerable; in addition, the frequency of visits to the Center for essentially non-medical reasons decreased considerably, with the greatest decrease in such visits occurring 6 to 15 months after termination of group treatment. This is the first part in a four-part series dealing with group therapy in family medicine.

Adult↗
PubMed1978

Group therapy in family medicine. Part 2: establishing the group.

This paper is the second in a four-part series and describes some of the prerequisites necessary for the establishment of a therapy group in family medicine. In setting up a group, it is necessary to have group leadsers, a supervisor, patients, a suitable room, and time set aside for the purpose. Referral sources and criteria for referral are presented, as well as a description of patient characteristics. Factors leading to referral are discussed, and contraindications for referral considered.

Family Practice↗
PubMed1978

Group therapy in family medicine. Part 3: starting the group.

This paper is the third in a four-part series and in it some issues and techniques pertaining to the pregroup screening interview are discussed as well as the initial meeting of a therapy group in a family practice setting. The screening interview enables patient and group therapists to decide whether or not the patient might benefit from group therapy. Topics covered in such an interview are discussed. Some ways of beginning and of ending the first session are described.

Family Practice↗