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Biomedical subjects

W S Goodman

Publications and source records attributed to W S Goodman.

At least 19 recordsLinked to original sources
PubMed1997

Strategies to increase the use of autogenous arteriovenous fistula in end-stage renal disease.

The purpose of this retrospective study was to review our experience with a consecutive group of end-stage renal disease (ESRD) patients using simple strategies to increase the use of autogenous vascular access, and determine whether the current trend of using synthetic bridge-graft fistula (BGF) rather than autogenous arteriovenous fistula (AVF), could be reversed, despite an aging population and broadening criteria for hemodialysis. All patients for vascular access surgery had careful preoperative clinical examination of the arm veins with outflow occlusion to determine the venous anatomy and continuity. Where no veins were apparent or their continuity in doubt, selective preoperative venography was performed. Where veins were unsatisfactory for forearm AVF, new or modified surgical procedures to use both the basilic and cephalic veins in the upper arm were performed. Intraoperative angioscopy was used to monitor vein quality and surgical technique. Ninety-eight primary vascular access procedures were performed in 76 patients, 75 (76.5%) AVF (forearm, n = 41; upper arm, n = 34) and 23 (23.5%) BGF. Forty-one of 76 (54%) had already had at least one previous access procedure prior to this study. More than one access procedure was needed in 16 patients. Preoperative venography was performed in 22 (22.4%) and intraoperative angioscopy in 45 (45.9%) of the 98 procedures. The number of revisions required to maintain patency was significantly higher for BGF (37 revisions in 14/23) than AVF (16 revisions in 13/75) (p < 0.0001, Poisson test) with an annualized secondary revision rate of 1.168 for BGF and 0.173 for AVF (p < 0.0001, Poisson test). AVF had both longer primary (p = 0.0001, log rank test) and secondary patency (p = 0.038, log rank test) than BGF. AVF as the primary vascular access can be significantly increased and the current trend of using BGF reversed with the use of simple clinical strategies to evaluate the suitability of the arm veins for vascular access.

Arm↗
PubMed1987

The anatomy of external rhinoplasty.

The results achieved in rhinoplasty are directly related to the surgeon's ability to elucidate how subtle changes in the bony and cartilaginous supports of the nose will alter its appearance. Therefore, any surgeon who performs rhinoplastic procedures requires a sophisticated knowledge and understanding of the anatomy of the nose. This article reviews the anatomy of the nose from the perspective of the external rhinoplasty approach.

Humans↗
PubMed1985

Augmentation in rhinoplasty--a personal view.

This paper presents a view on the use of various synthetic materials in rhinoplasty and the authors' preference for autologous bone as an augmentation material. The biology of bone transplantation as it applies to rhinoplasty is reviewed. Specific techniques for augmentation of the major saddle deformity are described, emphasizing the use of the external rhinoplasty approach for exposure as well as the authors' view that the dorsal graft should not extend beyond the cephalic border of the lower lateral cartilage. The senior author's experience with autologous bone as an augmentation material in 60 patients with major saddle deformities is reviewed. There were three patients whose grafts totally resorbed, and two cases of late graft fracture and displacement. The remaining patients had resorption graded as minor or insignificant. There were only two donor site complications--both wound seromas. Patients reviewed had been followed from one to 18 years.

Bone Transplantation↗
PubMed1984

The management of chronic external otitis.

Longstanding diffuse otitis externa can lead to irreversible skin changes, canal stenosis, and deafness. Although usually responsive to aggressive medical management, some cases prove refractory. Surgery consisting of a canalplasty and meatoplasty is recommended in these rare instances. The senior author's management of this disease is outlined in detail. Three refractory cases are described, of which two required and responded to surgery with satisfactory hearing and healing. The so-called "malignant external otitis" variety has been excluded from this report.

Adult↗
PubMed1982

The surgical closure of nasoseptal perforations.

Although nasoseptal perforations are uncommon--becoming even more so with early diagnosis and treatment of nasal trauma along with continuing refinements in septal surgery--a myriad of suggested techniques continue to exist for their closure. The conventional success rate is often unacceptably low so that Silastic prostheses are now being used to relieve the symptoms of septal perforation. The successful surgical closure of perforation of the nasal septum is still difficult. This treatment has been greatly facilitated by the use of the external rhinoplasty, without compromising the airway or causing cosmetic deformity. Supportive autogenous graft material is used routinely, while the perforation is closed using bilateral, bipedicled mucoperichondrial flaps. This paper omits a complete discussion of etiology. The indications for surgical correction are discussed in detail. The main contraindication to attempting correction is the size and the position of the perforation. The paper is based on 7 years' experience during which period 18 patients have had this surgery. The technical details of the operation are described with the aid of diagrams and photographs.

Humans↗
PubMed1981

Recent advances in external rhinoplasty.

The introduction, resistance to, and acceptance of external rhinoplasty are reviewed. Technical advances - butterfly incision, electrocautery, drainage incisions, and use of the rotating burr - are discussed; and illustrations are used to support the author's belief in advantages of the external approach.

Adolescent↗
PubMed1980

Tympanoplasty--25 years later.

The surgical details of tympanoplasty, the importance of the pathology, the proper selection and preparation of the patient have been emphasized. The results of the procedure have been discussed. While at times disappointing, the operation tympanoplasty as viewed over 25 years has been established in the armamentarium of the otologic surgeon.

Adult↗
PubMed1980

Ear surgery today.

Explore the source record for details and available documents.

Ear Diseases↗
PubMed1979

Infections of the temporomandibular joint.

Three interesting case histories of infection of the temperomandibular joint are reported. An unsuccessful search of the recent literature was made in the hope that some assistance would be obtained in understanding the pathology. These infections must have been more common in the pre-antibiotic era and perhaps a search of the older literature would have been more fruitful.

Abscess↗
PubMed1978

Nasoseptal perforation--closure by external septorhinoplasty.

The successful correction of perforations of the nasal septum is still difficult. This treatment has been greatly facilitated by the use of the external septorhinoplasty, without compromising the airway or causing cosmetic deformity. Supportive autogenous graft material is used routinely and bipedicled mucoperichondrial flaps are used when necessary. Seven consecutive patients have been successfully treated by this method.

Adult↗
PubMed1978

Why external rhinoplasty?

The indications for, advantages, and disadvantages of external rhinoplasty are considered from a pragmatic and philosophic point of view. The results in more than 200 patients are analyzed.

Evaluation Studies as Topic↗