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Biomedical subjects

C W Gross

Publications and source records attributed to C W Gross.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

A 3-year multi-institutional experience with the liposhaver.

OBJECTIVE: To report a 3-year multi-institutional clinical experience with the liposhaver in facial plastic surgery. DESIGN: Nonrandomized, nonblinded, multi-institutional evaluation of the liposhaver in a clinical setting. INTERVENTIONS: Seventy-two patients who presented for facial plastic surgical procedures underwent surgery with the liposhaver. Seventy-six liposhaving procedures and 74 concomitant procedures were performed. Standardized preoperative and postoperative photographs were obtained. OUTCOME MEASURE: Subjective evaluation by the surgeons who performed the procedures. RESULTS: The liposhaver was used successfully in all cases. The fat was cleanly shaved and the contour results were even, without dimpling or significant asymmetry. Operative time was comparable to that of conventional liposuction. There were no cases of facial nerve injury and no evidence of increased bleeding intraoperatively. Two male patients had small postoperative hematomas in the immediate postoperative period that were successfully treated with conservative measures. An additional patient developed a small hematoma on postoperative day 5 that was effectively treated with needle aspiration and a pressure dressing. CONCLUSION: This 3-year multi-institutional report suggests that the liposhaver continues to offer a precise alternative to conventional liposuction.

Equipment Design↗
PubMedDate not supplied

Toxic shock syndrome following functional endonasal sinus surgery: a case report.

Toxic shock syndrome (TSS) is a serious multisystem disease that was first described in 1978 by Todd. It occurs most often in menstruating women using superabsorbent tampons. The exact pathogenesis is not well understood, but it is felt to be due to the effects of an enterotoxin produced by certain strains of Staphylococcus aureus. The reported incidence of TSS following nasal surgery is 16/100,000. We report a case of TSS following endonasal sinus surgery in which minimal packing was used. The nasal surgeon should be aware of this rare and possibly fatal entity, as TSS may occur following any nasal/sinus surgery, even where packing is minimal and of short duration and when the patient is receiving antibiotic therapy.

Adult↗
PubMedDate not supplied

Pediatric functional endonasal sinus surgery: review of 210 cases.

Functional endonasal sinus surgery (FESS) is an effective treatment for chronic or recurrent sinusitis in children, most of whom have failed more conservative medical treatment. The endoscopes used in FESS allow direct visualization of the diseased tissue and restoration of physiologic mucociliary clearance, enabling the sinus mucosa to return to its normal condition after the procedure. For a period of 3 to 36 months, we followed the recovery of 210 children who underwent FESS between 1986 and 1989. The age range of the children at the time of the procedure was 14 months to 16 years. Eighty percent of these patients had improvement of their sinusitis. There were no major complications. Eight percent of the 210 children needed revision surgery. Pediatric FESS is a two-stage operation requiring follow-up nasal cleaning under general anesthesia. The most common findings during the second-stage endoscopy were adhesions and granulation formation.

Adolescent↗
PubMedDate not supplied

Teratocarcinoma of the ethmoid sinus: review of literature plus a new case report.

We report a third case of an unusual maligant neoplasm of the paranasal sinuses in a 60-year-old woman. Similar cases have been previously reported and called malignant teratoma. In consultation with Ackerman (written communication, February 1976) we propose the term "teratocarcinoma" and believe this is to be a more descriptive term and less likely to be confused with the generic term "teratoma," which is a benign tumor.

Ethmoid Sinus↗
PubMedDate not supplied

Efficacy of cefazolin as a prophylactic antibiotic in head and neck surgery.

The rationale for use of perioperative shortterm prophylactic antibiotics in prevention of postoperative infection in major head and neck surgery was reviewed. Cefazolin and placebo were compared in 50 patients and results showed that short-term perioperative cefazolin was a useful adjunct in reduction of postoperative infection. Findings suggest perioperative antibiotics may be safely and effectively used to reduce postoperative morbidity from infection after surgical procedures in volving skin and mucosa of the upper aerodigestive tract.

Adult↗
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Effects of fibrin sealant-containing antibiotics in a rabbit model of chronic sinusitis.

Postoperative complications of sinus surgery include bleeding, infection, and synechiae. Improved subjective outcomes in humans treated with fibrin sealant (FS) after endoscopic sinus surgery (ESS) have been reported. Streptococcus pneumoniae was used to initiate chronic sinusitis in occluded rabbit sinuses in order to evaluate the role of FS in mucosal healing. Six weeks later, all animals had maxillary antrostomies. Homologous FS-containing ciprofloxicin (100 mg/mL) and clindamycin (15 mg/mL) was applied topically to treatment rabbits (n = 9). Control rabbits (n = 10) received no antibiotics. Two weeks into the recovery phase after antrostomies, all animals were re-examined. Mucociliary transport velocity (mean +/- standard deviation in mm/minute) was measured in all sinuses (n = 38) during healthy (100% measurable, 13.82 +/- 4.16), infected (18% measurable, 4.74 +/- 0.42), and recovery phases (5% measurable, 6.30 +/- 4.67). In both groups, mucopurulent discharge was present in the majority of sinuses (control group 18/20, FS group 16/18). In addition, there was no significant difference in the recovery phase between the two groups when comparing changes in the size of antrostomies, light microscopy, or culture clearance. Scanning electron microscopy did suggest a possible improvement in ciliary regeneration in the FS group. Application of FS-containing antibiotics did not appear to improve healing after ESS in our rabbit model of chronic sinusitis.

Animals↗
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Follow-up of University of Virginia experience with the modified Lothrop procedure.

Current surgical treatment of the frontal sinus disease include external approaches to obliterate or ablate the sinus and both external and transnasal methods to restore drainage into the nasal cavity. The original Lothrop procedure resects the medial frontal sinus floor, superior nasal septum, and intersinus septum, creating a large frontonasal communication. However, as described, the external approach used in this procedure often allowed medial collapse of soft tissue and the stenosis of the nasofrontal communication. This report further relates our experience with the modified transnasal endoscopic Lothrop procedure using suction drills for cases in which frontal recess exploration had failed to relieve obstruction of the frontal sinus. We present an update of the University of Virginia experience in performing the modified Lothrop procedure in 20 patients from 10/93 to 4/95. Our findings over the follow-up period (average 12 months) have verified that this procedure is effective, with a 95% patency rate for the surgically enlarged frontal sinus ostium. When compared to osteoplastic flap with fat obliteration, the modified transnasal Lothrop procedure offers the advantages of a less invasive procedure with a shorter and usually no hospitalization, less morbidity, and the increased ability to evaluate post-operatively for recurrent disease. A patient charge analysis was also performed comparing patients undergoing frontal sinus obliteration during the same time period, revealing an additional benefit of decreased patient costs for the modified transnasal Lothrop procedure. None of our patients experienced complications, and all showed significant improvement, if not complete resolution of their symptoms. Although this procedure has produced favorable results, it should be noted that this procedure is technically demanding and will require further long term follow-up to verify its efficacy and proper role in the spectrum of surgical approaches for the treatment of chronic sinusitis.

Adipose Tissue↗
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The role of mini-trephination in the management of frontal sinusitis.

The surgical management of chronic frontal sinusitis remains an area of controversy. Since the introduction of endoscopic sinus surgery, many novel approaches to this difficult problem have been developed. Recently at the University of Virginia, mini-trephination of the frontal sinus has been used in combination with endoscopic frontal sinusotomy. This technique has enabled confident and precise identification of the frontal sinus ostium, culture of sinus contents, and irrigation of the frontal sinus. A retrospective review of 22 minitrephinations since November 1997 was performed. The short term results are encouraging with a frontal sinus patency rate of 90%; however, long-term follow-up is required. We conclude that the technique is reliable and reproducible.

Adult↗
PubMedDate not supplied

The diagnosis and management of sinusitis in children. Surgical management: an otolaryngologist's perspective.

Sinusitis is more common in children than frequently recognized. Proper medical and surgical management will result in a lessened incidence of complications, better management of certain coexisting medical conditions, and improved quality of life for the child. Medical therapy usually is effective in managing individual occurrences. However, surgical management is indicated in children not responding to therapy, in those with threatened or existing complications and in those with frequent recurrences despite aggressive medical management. The intranasal antrostomy procedure performed via the inferior meatus is a procedure that has great benefit and is underutilized.

Age Factors↗