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Biomedical subjects

A R Shons

Publications and source records attributed to A R Shons.

At least 37 records · Page 2Linked to original sources

The results of aggressive regional operation in the treatment of cancer of the floor of the mouth.

We reviewed the records of 94 patients with cancer of the floor of the mouth who were treated during a 15-year period to assess the results of an aggressive regional surgical approach. The primary tumor was excised with a 2 cm margin of normal tissue. A marginal or segmental mandibulectomy was performed in 84 of 94 patients. An ipsilateral radical neck dissection was performed in 86 of 94 patients. Contralateral suprahyoid dissection was combined with ipsilateral radical neck dissection in 52 patients. Bilateral radical neck dissection was performed in 10 patients. In the 1 to 16-year follow-up period, local/regional control was achieved in 91% of stage I patients, 83% of stage II patients, 68% of stage III patients, and 48% of stage IV patients. Determinant 5-year survival rates were T1--72%, T2--47%, T3--25%, and T4--28%.

Adult↗

Early histopathologic changes in experimentally replanted extremities.

Early serial histologic changes in replanted extremities have not been well defined; their contribution to a suboptimal functional result is unknown. With the use of a rat hind limb replantation model to address this question, we studied tissues of the replanted legs by light microscopy from 1 to 60 days after replantation. Although early lesions were consistent with ischemic injury, the chronic preparations were remarkably normal, and the lesions were more consistent with denervation. Poor function in clinical replantations may be a reflection of more pronounced versions of these pathologic lesions.

Animals↗

The use of methyl methacrylate in a two-stage correction of Crouzon's/Apert's deformity.

We have employed a two-stage operative approach to the correction of Crouzon's/Apert's deformity. Extensive use of methyl methacrylate in cranioplasty and frontal bone advancement is employed to obtain finely detailed contours with excellent stability. By adhering to principles of separation of oral contamination and the methyl methacrylate, as well as the provision of adequate soft tissue coverage of the methyl methacrylate, the problems of infection and soft tissue breakdown can be minimized.

Acrocephalosyndactylia↗

Facial fractures in trauma victims: the influence of treatment delay on ultimate outcome.

To obtain objective data on the consequences of delayed treatment of facial fractures we reviewed the records of 220 patients who had suffered facial fractures concomitantly with extrafacial trauma severe enough in its own right to warrant hospital admission. Fractures studied were those of the mandible, maxilla, zygoma, and frontal sinus. Seventy-three patients fit inclusion criteria. Most injuries occurred in motor vehicle accidents. Associated extrafacial injuries were common and frequently multiple, the more serious of which generally took priority over the facial injuries in the triage system. The two most common reasons for delay were instability of the patient's neurological status, or initial non-recognition or poor definition of the facial fracture. Delays in treatment ranged from 0 to 24 days. In patients with mandible fracture only, delay of up to 24 days in definitive treatment led to no noticeable increase in morbidity due to malocclusion, infection, or nonunion. In no other facial fracture did treatment delay lead to an increased incidence of complications. Retrospective analysis of the patients who did suffer complications almost always revealed predisposing conditions that placed these patients at higher risk for poor results.

Adolescent↗

A rigid transparent face mask for control of scar hypertrophy.

A rigid transparent face mask of cellulose acetate butyrate was developed for the control of scar hypertrophy in the burned face. Excellent patient acceptance has been found in a six-year series of 97 patients. Use of the device for at least twenty hours a day for an average of one and a half years per patient has enabled preservation of normal facial contours.

Adult↗

Plastic reconstruction after bypass surgery and massive weight loss.

In summary, the surgical techniques described can provide substantial benefit to selected patients who have sustained massive weight loss. As in all cosmetic surgery, patient selection must be meticulous. The expectations of the patient must be realistic, and the very real risks of the operative procedures must be understood. Patients who have sustained massive weight loss should be informed of the possibilities of reconstructive plastic surgery.

Abdominal Muscles↗

A physiologic approach to the problems of simutaneous bilateral neck dissection.

A number of physiologic derangements have been observed resulting from the management of head and neck cancer with resection and simultaneous bilateral neck dissection. A protocol evolved to minimize morbidity from these complications was used on seventeen patients. Eleven are alive and free of disease and there was no mortality.

Animals↗

Renal transplantation with blood supply by axillofemoral bypass graft.

An axillofemoral bypass was used to preserve a functioning renal allograft after excision of a mycotic abdominal aortic aneurysm in a diabetic patient. In the presence of continued immunosuppression the aortic wall infection progressed and the patient expired after rupture of the proximal aortic closure.

Adult↗

Cervical-pectoral flaps in the treatment of advanced oral cancer.

Twenty-two of 90 patients with carcinoma of the anterior oral cavity treated at the Minneapolis Veterans Administration Hospital from 1965 through 1973 had advanced lesions - tumors attached to the mandible and/or more than 3 cm in size. These patients were treated by primary radical neck dissection, en bloc excision, and segmental mandibulectomy. A cervical-pectoral flap combination was used for reconstruction. The functional and cosmetic results were excellent. Patient survival and cure rate compare favorably with other series. We emphasize the need for wide initial resection with immediate reconstruction.

Adult↗