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Biomedical subjects

B W Pearson

Publications and source records attributed to B W Pearson.

At least 37 records · Page 2Linked to original sources
PubMed1983

Deep facial osteology as revealed by coronal sections of the dried skull.

An understanding of the bony framework and relationships of the face is essential to the facial reconstructor. A dried human skull was immersed in a hardening agent to preserve the ethmoidal labyrinth and then cut in the coronal plane to produce six sections. The anterior and posterior surface of each section was photographed and landmarks were labeled. Since the thick anterior bony structures were removed with the first slice, the normal delicate laminae of the deep face, within the deeper sections, were exposed for study.

Facial Bones↗
PubMed1982

Superior laryngeal neuralgia: carotidynia or just another pain in the neck?

A clinical pain syndrome similar to "carotidynia" developed in a patient several years after undergoing carotid endarterectomy. The pain was reversed by superior laryngeal nerve block, followed by superior larnygeal neurectomy. A diagnosis of superior laryngeal neuralgia was suggested by several characteristic features: (1) pain along the anterior cervical triangle, with extension to the ipsilateral ear and eye, (2) hoarseness, and (3) paralysis of the ipsilateral cricothyroid muscle on laryngoscopy. Carotidynia usually refers to neck pain arising from the carotid artery in the neck and is often viewed as a migraine variant. Our observations suggest that carotidynia may not be a migraine variant and that "carotidynia" may not be an accurate term for all pains in the anterior cervical triangle. We suggest that evaluation of neck pain include speech pathology and otolaryngologic consultations (including laryngoscopy) if any voice disorder is reported or noted. Since the superior laryngeal nerve is the neural structure most contiguous to the bifurcation of the carotid artery, the superior laryngeal nerve may have become entrapped in a fibrotic process that developed after carotid endarterectomy. Such pain may be a rare complication of carotid endarterectomy. When other causes have been excluded and pain continues, a superior laryngeal nerve block should be considered.

Carotid Arteries↗
PubMed1982

Extracranial internal carotid artery aneurysms.

Extracranial internal carotid artery aneurysms are uncommon. The symptoms of these aneurysms vary according to their location and size. Larger aneurysms may present as cervical or parapharyngeal masses, which may or may not be pulsatile or tender; there may be an associated systolic bruit. Pharyngeal hemorrhage, epistaxis, or bleeding from the ear are rare manifestations. Ischemic symptoms are a frequent mode of presentation of these aneurysms. Arterial diseases, particularly atherosclerosis, may predispose the vessel to the formation of the aneurysm. Sometimes trauma is the cause. We report herein six cases of extracranial internal carotid artery aneurysms. The modes of presentation, the etiologic factors, the pathologic observations, and the methods of management are discussed, and the pertinent literature is reviewed.

Adult↗
PubMed1981

Subtotal laryngectomy.

A subtotal laryngectomy may meet the requirements of adequate tumor resection in many patients who normally would undergo total laryngectomy. The uninvolved column of innervated endolarynx sacrificed at total laryngectomy to separate the airway and the food way can be preserved to valve a speaking shunt. Such a shunt remains patent and sphincteric without the use of a prosthesis an offers consistent advantages over "post-total" laryngectomy reconstructions. This report describes the principles of subtotal laryngectomy applied in 16 patients with laryngeal or pharyngeal carcinoma. The technique ensures entry into the larynx through tumor-free soft tissues and keeps the tumor margins under direct vision thereafter. During follow-up ranging from 6 months to 6 years, fistula speech has been retained and no local tumor has recurred.

Carcinoma↗
PubMed1980

Follow-up on maxillary artery ligation for epistaxis.

Forty-six transantral maxillary artery ligation cases were compared with 30 controls with regard to the outcome of their treatment of epistaxis. The success rate and the complication rate were higher in the ligated patients. Maxillary artery ligation for severe idiopathic epistaxis is a valid procedure only if injury to the infraorbital nerve is avoided.

Epistaxis↗
PubMed1980

Extended hemilaryngectomy for T3 glottic carcinoma with preservation of speech and swallowing.

Total laryngectomy is often applied in the treatment of invasive squamous cell carcinomas that fix one side of the larynx. The major drawback, of course, is loss of the voice. In many instances, however, preservation of the uninvolved portion of the larynx is compatible with adequate tumor margins, and the preserved laryngeal remnant, although it cannot be reconstituted to allow breathing, can readily be used for voice. The principle involved is the creation of a valved tracheopharyngeal shunt, which functions as a neoglottis during expiration but constricts to close during swallowing. To accomplish this the recurrent laryngeal nerve and the myomucosal segment of intrinsic glottic musculature to which it is attached is preserved on the uninvolved side. The myomucosal segment is formed into a mucosal lined tube by releasing the soft tissues from the cartilage. The diameter and flaccidity of the tube is augmented by incorporating a flap of hypopharyngeal mucosa. Safe performance of this operation depends on careful preoperative evaluation and laryngoscopic verification and a close-working relationship with an interested surgical pathologist. The first 7 consecutive cases in which this management program has been applied are presented in review. The patients, ranging in age from 58 to 69 years old, had T3 grade 2 or 3 invasive squamous cell carcinoma. The average hospitalization was 13 days. The longest follow-up is 5 years. Clear surgical margins, local control of the disease, and satisfactory voice without significant aspiration have been achieved thus far in each case. The average subglottic pressures measured at the tracheotomy were 25 +/- 6 cm. of water (threshold opening) and 43 +/- 20 cm. of water (for phonation). Whether these encouraging initial results can be widely duplicated will probably depend on the care with which cases are selected. The dangers of applying this surgery to patients with extensive submucosal spread will be obvious to experienced laryngologists.

Aged↗
PubMed1979

Successful management of bilateral carotid-cavernous fistulae with a trans-sphenoidal approach.

A patient with traumatic bilateral carotid-cavernous fistulae was successfully treated by an entirely extracranial approach. The larger fistula on the left was exposed via a transethmoidal, trans-sphenoidal route and was directly opened and packed while the cavernous carotid artery was stented open by an intraluminal balloon catheter. The balloon catheter provided temporary hemostasis and was removed after the fistula had been packed. The left carotid artery remained patent, and the smaller fistula on the right was subsequently obliterated by a balloon catheter. The fistulae have remained cured, and the left internal carotid artery supplies the cerebral circulation.

Adult↗
PubMed1979

The transseptal approach to lesions of the pituitary and parasellar regions.

In a series of 505 consecutive procedures, the transseptal-transsphenoidal pituitary operation has proved safe and effective. The overall mortality in this series is 1.39%. A wide variety of sphenoid and sellar lesions and nearly every pituitary adenoma have been found suitable for the exposure provided through the sublabial-transseptal approach. This statement rests on the premise that both the rhinologist's and the neurosurgeon's skills are optimally applied to each case. The role of the otorhinolaryngologist is defined in this paper, and the benefits of the team approach are explored. An interpretive history of the transsphenoidal approach is presented, and the evolution of the transseptal technique developed at the Mayo Clinic from 1972 to 1978 is reviewed. Emphasizing the rhinologic aspects, all details of the surgical technique are described and illustrated. Our experience with the special endocrine syndromes is also reviewed to spotlight clinical features that require individual consideration by the rhinologic surgeon.

Anesthesia↗
PubMed1977

Gross and microscopical blood supply of the trachea.

Twenty-one human tracheal specimens were perfused and dissected, 10 with conventional techniques and 11 with clearing and microdissection techniques. The lateral pedicles of the trachea and esophagus induct vessels from the inferior thyroid, subclavian, supreme intercostal, internal thoracic, innominate, and superior and middle bronchial arteries. These vessels are interconnected along the lateral surface of the trachea by an important longitudinal vascular anstomosis. From the 2 lateral longitudinal anastomoses the lateral and anterior tracheal walls receive their blood supply through transverse segmental vessels that run in the soft tissues between the cartilages. These transverse vessels interconnect the longitudinal anastomoses across the midline and feed the submucosal capillary network that arborizes richly beneath the endotracheal mucosa. The tracheal cartilages receive nourishment from the capillary bed applied to their internal surface. The esophageal arteries and their subdivisions that supply the posterior membranous wall of the trachea contribute almost nothing to the circulation of the cartilaginous walls.

Arteries↗
PubMed1975

Laryngeal microcirculation and pathways of cancer spread.

The microcirculation of the human larynx was studied in cleared anatomic specimens. The distribution of the endolaryngeal blood supply was constant enough to permit naming of the subdivisions of the superior and inferior laryngeal arteries. There was a remarkable correlation between arteriolar and capillary distribution and the laryngeal routes of cancer spread within the larynx. Compartmentalization of the larynx was not apparent. The paraglottic space was filled with blood vessels.

Adult↗