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Biomedical subjects

W P Work

Publications and source records attributed to W P Work.

At least 19 recordsLinked to original sources
PubMed1988

Adjustable dissection and surgical table as an aid to teaching.

An adjustable dissection and surgical table for teaching residents, fellows, staff, and other medical and allied health personnel about anatomy and simulated techniques of surgery in the laboratory setting is described. The table can be attached to a standard House-Urban temporal bone dissection bench. The temporal bone laboratory can thus serve a dual purpose in teaching ear and soft tissue anatomy and surgical techniques of the head and neck. In this setting such a dual purpose laboratory can often include basic and clinical research activities as a third function.

Dissection↗
PubMed1986

Surgical treatment of recurrent pleomorphic adenoma of the parotid gland.

Recurrent pleomorphic adenomas of the parotid gland warrant consideration because of the potential for facial nerve injury occurring with surgical treatment and the risk of malignant conversion. Forty-eight cases of recurrent pleomorphic adenoma treated at the University of Michigan, Ann Arbor, between 1935 and 1975 were retrospectively analyzed. The results of surgical procedures for recurrence were determined with respect to tumor control and resultant facial nerve function. Malignant conversion developed in three (6%) of 48 cases. The results of this study underscore the importance of adequate surgical excision of initial recurrences as well as primary tumors to prevent tumor recidivism. Tumor control rates and facial nerve preservation are enhanced with formal parotidectomy for recurrent tumor when feasible. In cases in which facial nerve identification and dissection is not possible, en bloc total parotidectomy offers effective, though not absolute, control of extensive recurrence.

Adenoma, Pleomorphic↗
PubMed1981

Non-neoplastic disorders of the parotid gland.

The parotid glands are subject to many pathological disorders other than neoplastic diseases. This large group of disorders is classified for the parotid glands into infectious, metabolic and endocrine, traumatic, congenital, and acquired cystic diseases. The other major salivary glands also can be affected by many of these conditions. In recent years more and more patients have been examined and treated who have had diseases classified according to our concepts. Surgical procedures are now commonly recommended for these groups of patients not only for diagnosis but for treatment as well. The microscopic examination of permanently prepared, stained excised tissues still remains the final diagnostic procedure in most patients in spite of more recently developed diagnostic techniques. Further, the well trained surgeon of today is in a position to assure the patient that permanent injury to the facial nerve trunk or to its branches is only a remote possibility. Lastly, our medical and surgical experiences are discussed in the following groups of patients: those with acute suppurative sialadenitis, those with acute abscess, those with chronic obstructive and non-obstructive sialadenitis, those with traumatic lesions, those with congenital lesions, and those with acquired cystic lesions.

Abscess↗
PubMed1979

Acinic cell carcinoma: a clinicopathologic study of thirty-five cases.

A clinicopathologic study of 35 cases of acinic cell carcinomas is presented. Complete follow-up information was available on 31 patients (average period, 7-5 years). The malignant potential of these neoplasms is affirmed by observations that metastases (local and distant) occurred in nine patients and that eight patients died as a consequence of their carcinoma. Retrospective classification of the carcinomas into high and low grade lesions correlated well with ultimate biologic behavior but is unlikely to be successful in an intra-operative (frozen section) mode. This limitation is due to: (a) sampling limitations at the time of primary surgery and (b) the malignant behavior of the occasional low grade carcinoma. Histologic features characterizing high grade carcinomas are local aggressive infiltration and areas of the tumor that appear analogous to the embryonic and post-embryonic terminal tubules and intercalated ducts. The best opportunity for cure of these neoplasms lies in their complete surgical removal at the time of initial treatment. For this, a total parotidectomy is the procedure of choice. Enucleation and local excision is to be condemned.

Adolescent↗
PubMed1978

Teratomas of the neck in adults.

True teratomas of the neck in adults are unusual neoplasms. Their clinicopathologic aspects are distinctly different from the counterpart tumor of the neonate and infant. While the latter is almost always a benign tumor, adult teratomas are both histologically and clinically malignant neoplasms. To our knowledge, we report the tenth case of a teratoma of the neck in an adult.

Aged↗
PubMed1976

Recurrent benign mixed tumor and the facial nerve.

In surgical treatment of patients with recurrent benign mixed tumor, the surgeon strives to preserve the facial nerve. If there is inadvertent nerve injury, immediate repair is the treatment of choice. We report two patients with recurrent benign mixed tumor in whom the facial nerve was deliberately sacrificed. Repair of the nerve was accomplished by nerve grafts. Gross and microscopic tissue examination are presented in each instance, supporting the concept of en bloc removal of tumor and nerve. Such a surgical procedure is reserved only for a highly selected group of patients.

Adenoma, Pleomorphic↗
PubMed1976

Lymphomas of the masticator space.

Lymphomas that involved the masticatory space occurred in three patients. In one patient, the masticator space remained the sole manifestation for many years; in the other two patients, the masticator-space involvement was a local manifestation of constitutional disease. In all three patients, excisional biopsies and microscopical tissue examinations were carried out because of a mass deep to the parotid gland. The symptoms and signs are quite similar to those manifested in patients with infection. Surgical procedures other than incisional biopsy are not indicated. Irradiation and chemotherapy appear to be the treatments of choice.

Adult↗
PubMed1976

Bilateral asynchronous mixed tumors of the parotid gland.

Bilateral occurrence of benign mixed tumors of the salivary glands is rare. Simultaneous involvement of the submandibular and parotid glands has been described. Multicentric foci in the parotid gland has also been reported. Only four cases of bilateral mixed tumors, occurring simultaneously and confined to the parotid glands, have been reported. We report the first known cases of bilateral asynchronous benign mixed tumors of the parotid and review the pertinent literature.

Female↗
PubMed1976

Anomalies of the first branchial cleft.

Eleven cases of first branchial cleft duplication anomalies are classified into types I and II. Type I defects are associated with the first cleft and are duplication anomalies of the membranous external auditory canal. Type II defects are associated with the first cleft and first and second arches, and, as such, are associated with defects of the membranous external auditory canal and cartilaginous elements. Microscopical examination of tissue in type I anomalies shows a cyst lined by skin without adnexal structures and without cartilage. Type II anomalies usually contain all elements. Misdiagnosis, infection, and recurrences are common with these lesions. Clinically, they may drain through the neck and external auditory canal. Surgical excision must be complete or there will be recurrence. The facial nerve must be identified and protected during the excision.

Adolescent↗
PubMed1976

A radiologic advance in the diagnosis of disorders of the larynx.

The cervical spine greatly reduces the usefulness of anteroposterior soft tissue radiologic examination of the larynx. Fractures of the laryngeal and cricoid cartilages are difficult to diagnose by soft tissue technique, and time-consuming laminagraphy is often required. A new technique for single exposure anteroposterior soft tissue radiography of the cartilages and airway is described. An esophageal cassette containing ultraspeed dental film placed in a retrolaryngeal position is shown to yield detailed radiographs of high contrast. The feasibility of this technique is illustrated by the presentation of radiographs from patients with laryngeal disorders. The new technique is compared with existing examinations available to the clinician and its application in other disorders of laryngeal cartilages and soft tissue is discussed.

Fractures, Bone↗
PubMed1976

Arytenoidectomy revisited.

The spectrum of disabilities attendant to laryngeal paralysis range from mild hoarseness to complete upper airway obstruction depending upon the static position of the paralyzed cord or cords. The most distressing disabilities are those of bilateral vocal cord paralysis in which both vocal folds are fixed in the midline resulting in severe upper airway obstruction. Clearly the most acceptable solution to the problem of persistent laryngeal paralysis is through the establishment of normal neuromuscular integrity by vagal repair or neural transfer techniques. While electromyographic evidence of reinnervation and some restoration of cord motion has been described, synchronous neuromuscular activity is, at best, unpredictable and generally unsuccessful. Successful reinnervation procedures depend in part on early repair and herein lies a disparity between experimental work and its clinical applicability. Given the realities of delays in diagnosis and the unpredictability of operative reinnervation of the paralyzed larynx, we rely on alternative methods of improving the compromised glottic airway consequent to bilateral recurrent nerve paralysis of the larynx. During the period 1962 through 1974, 23 patients with complete bilateral paralysis of the larynx have been treated by the posterior extralaryngeal approach originally described by Woodman. The following is a description of the operative technique utilized with technical modifications which we consider important in enhancing operative results.

Adolescent↗