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Biomedical subjects

C N Ford

Publications and source records attributed to C N Ford.

At least 55 records · Page 3Linked to original sources
PubMed1986

Collapse of the ear canal during masking for bone conduction.

Although it is well recognized that collapse of the external meatus can mimic a conductive hearing loss in the test ear, attention must also be directed to the masked ear during masked bone conduction threshold testing. Failure to recognize collapse of the masked ear may result in a false air-bone gap in the test ear. Two such cases are presented and the mechanism analyzed. Suggestions as to identification and resolution of this problem are discussed.

Acoustic Impedance Tests↗
PubMed1985

Neurotropic melanoma of the face invading the maxillary nerve.

Neurotropic melanoma is a variant of desmoplastic melanoma which, in addition to a spindle-cell vertical component and fibrosis, exhibits a fascicular growth pattern and invades cutaneous nerves. Here we describe a neurotropic melanoma which arose in a small lentigo maligna melanoma and invaded the maxillary nerve for a distance of 5 cm. Ultrastructural features were similar to those of previously described neurotropic melanomas and tumor fascicles contained S-100 protein and neuron-specific enolase immunoreactivity.

Facial Neoplasms↗
PubMed1985

A nasal prosthesis for treatment of nasal airway obstruction.

Surgery is not always the best approach for immediate resolution of nasal airway problems. In some instances, surgery may be deferred, unnecessary, contraindicated or frankly refused by the patient. For some of these patients, the use of a simple intranasal prosthesis to enhance the passage of air through the nasal valve region is beneficial. Five patients meeting these criteria were fitted with a prosthesis and carefully evaluated pre- and postinsertion with rhinomanometry. Other situations are discussed where such a prosthetic device might be helpful.

Adult↗
PubMed1984

Preservation of periosteal attachment in lateral osteotomy.

Cosmetic rhinoplasty with narrowing of the bony vault can potentially reduce the nasal airway. Current surgical methods may aggravate this problem. In an attempt to demonstrate the effect of lateral osteotomy on the resultant airway, 4 cadaver specimens were studied grossly and with CAT scans. It appeared that variations in osteotomy technique did have a demonstrable impact on the size of the nasal airway. An interrupted transperiosteal approach, preserving intervening strands of periosteum, resulted in a more stable nose with less compromise of the airway.

Cadaver↗
PubMed1984

Injectable collagen in laryngeal rehabilitation.

Glottic insufficiency has been successfully managed by Teflon augmentation of paretic vocal cords over the past two decades. Collagen fulfills the criteria for a suitable bioimplant and is an attractive alternative as it is a normal constituent of the extracellular protein matrix. This study explores the use of modified bovine collagen injected into the canine larynx. Clinical situations are simulated by creating lesions and injecting collagen at different sites. The technique permits precise placement and quantification. Histologic study of the collagen implant fails to show evidence of significant foreign body reaction. The injected collagen appears similar to viable connective tissue and is colonized by host fibroblasts and nourishing capillaries.

Animals↗
PubMed1983

Techniques to enhance utilization of advancement flaps.

Utilization of advancement flaps to cover facial defects is potentially limited by the secondary distortion of adjacent anatomical landmarks, expansion of any residual lesion, and the vascular embarrassment of wound closure under tension. In this study, advancement flaps are raised in piglets, and the first stage in the serial excision of a hypothetical skin lesion is simulated. It is demonstrated that undermining of the lesion-bearing skin results in expansion of the lesion and is counterproductive. If, however, a separate layer of hypodermis and fascia is mobilized deep to the lesion and sutured to the advancing flap, skin closure can be accomplished with minimal tension. This results in maximal recruitment of the advancement flap and minimal expansion of the residual lesion as the defect is bridged.

Animals↗
PubMed1983

Candida epiglottitis.

Acute epiglottitis is most commonly of bacterial origin. A case of Candida epiglottis in a healthy, nondebilitated patient is reported. A literature search did not produce a previously reported case.

Acute Disease↗
PubMed1983

Serial excision and advancement flaps in the management of facial lesions.

Large facial lesions may be eradicated and replaced with anatomically normal-appearing adjacent skin by serial excision. The same properties that allow skin flaps to move and expand may cause undesirable spreading of lesion-bearing skin. Since scar contracture does not induce physiologic stretching of adjacent normal skin, it is more difficult to resolve third-degree burn deformities by serial excision. Certain anatomic regions present difficulties because of the relative immobility of skin and the risk of conspicuous deformity resulting from the secondary motion induced by advancement of the local flap. Discrete undermining and differential tissue approximation afford effective utilization of serial excision in these situations.

Adolescent↗
PubMed1983

Significance of apparent intratympanic meningiomas.

Meningioma is the most common tumor of the central nervous system, but it has only been reported in 79 patients to involve the temporal bone. The 4 cases presented here show striking clinical similarity to a subgroup of 20 meningiomas reported to be entirely intratympanic; however, in each instance the extent, origin, and potential of the disease was not initially evident. Precise histopathologic diagnosis may be aided by electron microscopy. Current concepts of embryology lend credence to the possible role of arachnoid endothelial cells in the pathogenesis of intratympanic meningioma. An advanced intracranial meningioma may be overshadowed by the hearing loss, tinnitus, and otalgia calling attention to an intratympanic component. The clinician should remain suspicious of intracranial disease even after excision of an apparently well circumscribed intratemporal lesion. Progressive sensorineural hearing loss and persistent otalgia portend recurrent or intracranial disease. Follow-up for at least 10 years with judicious use of CT scans is suggested.

Adolescent↗
PubMed1983

Lessons from the network and next steps: the Wisconsin Head and Neck Cancer Network.

In summary, the Wisconsin Head and Neck Cancer Control Network was formulated with the primary charge of improving the management of patients with head and neck cancer throughout the State. Detailed data on over 1500 patients representing 80 percent of all head and neck cancer patients in the State of Wisconsin was gathered, reviewed for quality, and analyzed. The data base consisted of information on the symptoms, signs, physical findings, treatment, complications, morbidity, and outcome. Although it was the impression of Network members that lesions were being noted earlier and treatment perhaps more effective, it was not possible to document this impression with the available data. The benchmarks of success of the overall project were numerous, however, particularly in the areas of public and professional education. The individuals reached were extremely receptive to new information. Several patients indicated that their dentist and dental hygienists, for example, were performing more thorough oral examinations. The effort was successful in establishing a network of physicians and institutions throughout the State cooperating with a common interest. It is hoped that in the future we can continue to build on the experience of the Network. Follow-up data has continued to accumulate through a largely voluntary effort of the coinvestigators, and this will enhance the value of the data base. Such follow-up data will certainly facilitate ongoing and future research projects based on this comprehensive information. To date, one publication has been prepared since termination of the project using the data base.

Data Collection↗
PubMed1982

Results of endolymphatic sac surgery in advanced Meniere's disease.

A rational surgical approach to Meniere's disease eludes us because of the uncertainty of the pathophysiology and the variability in the natural history of the disease. The results of different surgical techniques are difficult to compare because of differences in patient selection, methods of analysis, and length of follow-up reported. This study reviews long-term results in twenty-four ELS procedures in which the test group and parameters of evaluation are carefully described. The overall rate of vertigo control is 75 percent and incidence of significant hearing improvement is 25 percent. This low rate of hearing improvement is related to the selection of patients with advanced disease and other factors. In this series, surgery limited to simple decompression of the ELS proved generally more effective than shunt procedures. It is noteworthy that the Arenberg valve implant provided impressive results in a small number of revisions. Postoperative fibrosis appears to affect results adversely, therefore, measures to prevent scar tissue proliferation seem indicated.

Cicatrix↗
PubMed1978

Metastatic squamous cell carcinoma of the lip.

Squamous cell carcinoma of the lip is a common lesion that is not always acknowledged as a potentially lethal disease. We reviewed the cases of 27 patients with metastatic squamous cell carcinoma of the lip. Our data confirm that patients in an older age group are at greater risk for development of metastases than the general population of patients with squamous cell carcinoma of the lip. We also found a universally grave prognosis for patients who exhibit fixation of tumor to the mandible or erosion of the mandible. We were unable to confirm a greater risk for development of metastases among more advanced (T3 and T4) lesions. A number of our patients had T1 and T2 primary lesions. We also could not establish a relationship between a patient's delay before seeking medical assistance and subsequent development of metastases.

Adult↗
PubMedDate not supplied

Factors influencing functional outcome in supraglottic laryngectomy.

BACKGROUND: The relationship between preoperative pulmonary function tests (PFTs) and postoperative aspiration and deglutition complications in supraglottic laryngectomy (SL) has not been adequately analyzed. The effects of numerous other variables are either controversial or have not been studied. METHODS: A retrospective chart review was performed on 46 SL patients, analyzing preoperative PFTs and arterial blood gases, demographic factors, stage of disease, extended resections, cricopharyngeal myotomy, hyoid preservation, neck dissection, and postoperative radiotherapy with regards to aspiration and deglutition problems. RESULTS: Eighteen (39%) patients had no problems, 15 (33%) had moderate problems, and 13 (28%) had severe problems; of these, 39 (85%) were ultimately successful with no further swallowing dysfunction, whereas seven (15%) suffered intractable aspiration difficulties. Decreasing FEV1/FVC was significantly correlated with a poorer outcome, as was a greater number of pack-years of smoking. The effect of FEV1/FVC was shown to be independent from pack-years, whereas the converse was not clearly demonstrated. Extensions of the standard procedure did not correlate significantly with increased problems. CONCLUSIONS: An FEV1/FVC less than 50% signifies a greater risk for severe aspiration and deglutition complications, although it must be regarded as one factor among many in determining operability. With careful attention to reconstruction, extensions of the standard SL procedure can be safely performed.

Adult↗
PubMedDate not supplied

Selected problems treated by vocal fold injection of collagen.

INTRODUCTION: This study evaluates the results of vocal fold injection of bovine collagen. METHODS: A group of patients were selected because they were not good candidates for other forms of treatment. This included patients with scarred vocal folds, bilateral vocal fold pathology with a small glottic gap, and unilateral vocal fold pathology with atrophy. Assessment used patient self-evaluation, perceptual judgments of voice recordings, laboratory data based on acoustic signal analysis, and aerodynamic measures during voice production. Vocal folds were also studied by videostroboscopy. RESULTS: Most of the 45 patients treated with collagen injection were helped. In some cases, the improvement was marginal but documented using a variety of measures. Significant improvement was noted in jitter (P = .002), shimmer (P = .002), and maximum intensity (P = .026). There were no major complications and no hypersensitivity reaction. CONCLUSION: This study demonstrates the potential usefulness of collagen injection in the treatment of a selected group of patients with glottic insufficiency who are not good candidates for other forms of therapy. Objective analysis of results suggest improved function in this difficult to treat patient population. Further clinical investigation is warranted.

Animals↗
PubMedDate not supplied

An epidemiologic study of oral cancer in a statewide network.

A case-control study was conducted to investigate the risks of male and female oral, oropharyngeal, and hypopharyngeal cancer associated with poor oral health, mouthwash use, occupation, histories of tobacco and alcohol use, and other factors. Data were collected from all newly diagnosed patients entered into the Wisconsin Head and Neck Cancer Network over an 18-month period (N = 623). The prevalence of painful or ill-fitting dentures was significantly higher among males and females with oral cavity cancer. Relative risks for painful dentures were 5.97 (males) and 1.60 (females); for ill-fitting dentures, the relative risks were 3.15 (males) and 2.15 (females). For males, high relative risks of oropharyngeal cancer were also found to be associated with these indicators of poor dentition. Other indicators of poor oral health, including toothbrushing frequency and prevalence of broken teeth, were not associated with oral cancer. Mouthwash use was not found to carry a risk of oral cavity, oropharyngeal, or hypopharyngeal cancer. The risks of upper aerodigestive cancers with smoking and alcohol were confirmed for males, and lifetime use patterns were explored. Notable sex differences in exposure to alcohol and tobacco were found. There was little evidence that past alcohol use was related to female oral cancer.

Alcohol Drinking↗