Biomedical subjects
Publications and source records attributed to W S Dinerman.
Lymphangiomatous macroglossia, or giant tongue, usually presents within the first two years of life. The tongue enlarges to the point of protrusion from the mouth with resultant ulceration and frank necrosis of the tip. There may be associated malocclusion and prognathia produced by the enlargement of the tongue. The pathology and clinical manifestations of lymphangioma of the tongue are discussed in this paper, and a case report is presented.
Chylous fistula following radical neck dissection is a disturbing and potentially serious complication. Meticulous surgical technique in the areas of the thoracic duct on the left and the lymphatic ducts on the right will usually prevent the occurrence of a chylous leak. If one should develop, however, a pressure dressing alone is usually not sufficient to tamponade the leaking vessel. The patient should be returned to the operating room where the leak is identified and ligated. Loss of chyle from the body will rapidly deplete the body stores of fluid, proteins, and electrolytes. Careful monitoring of serum electrolytes and proteins and accurate replacement of these substances is essential. The anatomy, physiology, surgical technique, and treatment of the lymphatics and chylous fistulas at the base of the neck are considered herein.
A case report of pigmented villonodular tenosynovitis involving the temporomandibular joint is presented. The lesion had destroyed the ascending ramus and condyle of the mandible, anterior cartilaginous wall of the external auditory meatus, and a large part of the squamous portion of the temporal bone. Surgery included resection of a portion of the mandible, temporal squama, and dura of the temporal lobe with replacement by a fascia temporalis graft. Four years postoperatively, the patient is free of any evidence of recurrent disease. A discussion of the differential diagnosis of an infratemporal mass, natural history, and pathology of pigmented villonodular tenosynovitis are discussed herein.