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Biomedical subjects

G A Sisson

Publications and source records attributed to G A Sisson.

105 records · Page 6Linked to original sources
PubMedDate not supplied

Mediastinitis and neck abscess following cervical spinal fracture.

Neck abscess and mediastinitis are rare complications of cervical spinal injury. Often there is a delay in diagnosis because the physical and laboratory signs of abscess are falsely attributed to the vertebral injury. Prognosis is directly related to the expediency of recognition of infection and surgical drainage. Three cases of neck abscess with mediastinitis that were seen over a four-year period at the spinal cord unit at Northwestern Memorial Hospital are reviewed.

Abscess↗
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Femoral shaft fractures in children treated with early spica cast.

We retrospectively reviewed 51 patients aged 3-11 years with femoral shaft fractures selected for treatment with early spica cast immobilization. Shortening greater than 20 mm was the most common complication, occurring in 22 (43%) of the 51 patients. Factors associated with unacceptable shortening were shortening at the time of spica cast application greater than 10 mm, shortening greater than 20 mm at initial examination, and increasing age. Achieving less than 1 cm shortening at the time of cast application and close follow-up during the first 2 weeks after cast application are advised in order to achieve an acceptable final outcome.

Casts, Surgical↗
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Posterior commissure laryngoscope for carbon dioxide laser surgery.

A laryngoscope has been developed for microlaryngeal laser surgery in the posterior commissure of the larynx. The tip has been designed to facilitate exposure of one entire arytenoid and the posterior commissure. Other features include a concavity on the superior lip of the tip to hold the endotracheal tube anteriorly, a bifurcated smoke evacuation channel and a nonreflective finish. It is anticipated that this laryngoscope will be available in pediatric and adolescent sizes in addition to the adult size that we have worked with.

Humans↗
PubMedDate not supplied

Osteomyelitis of the clavicle.

Osteomyelitis of the clavicle is rare; however, it may occur following head and neck surgery. Risk factors include radiation, long-standing tracheitis, disruption of the periosteum or the cortical bone with interruption of the blood supply to the clavicle. Proper management includes early diagnosis, surgical debridement of soft tissue and bone, appropriate antimicrobial therapy, and coverage of the defect with a myocutaneous flap to protect the great vessels of the upper mediastinum.

Clavicle↗
PubMedDate not supplied

Voice preservation in pyriform sinus carcinoma by hemicricolaryngopharyngectomy.

Hemicricolaryngopharyngectomy was performed for anterior pyriform sinus carcinomas with preservation of voice and swallowing. The surgical specimen includes the homolateral half of the hypopharynx, larynx, and cricoid ring. The pharynx is reconstructed with a pectoralis myocutaneous flap, a deltopectoral flap, skin or dermal graft. A semirigid mucosa-lined speech tube is created by folding in the remaining half of the larynx. This tube, which is 4 to 5 mm in diameter, serves as a phonatory structure. Speech is produced by occluding the stoma with the finger and shunting air via this dynamic pseudolarynx. Patients maintain a permanent tracheostomy. Our experience includes 14 cases with up to 4-year follow-up.

Humans↗
PubMedDate not supplied

Endoscopic management of selected early vocal cord carcinoma.

Twenty-five previously untreated patients with selected early midcordal squamous cell carcinomas have been treated by endoscopic excisional biopsy with the carbon dioxide laser and followed for a minimum of 3 years. Twenty-four of the 25 patients are alive and free of disease, and one patient died of local and regional recurrence 2 years after attempted endoscopic excision followed by partial laryngectomy. Indications, contraindications, advantages, and complications associated with this treatment option for patients with early glottic carcinoma are discussed.

Carcinoma, Squamous Cell↗
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Management of chronic aspiration by subtotal and submucosal cricoid resection.

Modern techniques of conservation surgery of the laryngopharynx often result in narrowing, immobility, and decreased sensation of the hypopharynx. These procedures also compromise the most vital function of the larynx--protection of the airway. Permanent tracheostomy is always necessary for protection of the airway. Teflon injection, cartilage implant to the larynx, and extended pharyngeal myotomy can provide only temporary relief. Swallowing studies under fluoroscopy as well as laryngopharyngoscopy verify a narrowed pharyngeal inlet with the pharynx trapped between the cricoid and the cervical spine. Extrapharyngeal, subtotal, submucosal resection of the posterior cricoid ring results in a flaccid posterior laryngeal wall and enlarged hypopharyngeal inlet. At the same time the laryngeal inlet is narrowed, reducing aspiration and still preserving the voice.

Animals↗
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Lymphatics of the floor of the mouth and periosteum: anatomic studies with possible clinical correlations.

An anatomic study is made to determine the role of the periosteum in the lymphatic drainage of the floor of the mouth in the dog. Microsurgical techniques are used to cannulate and perfuse a lymphatic vessel. Pathways are dissected to the proximity of the mandible, where a full-thickness mucoperiosteal flap is elevated. It is found that the floor-of-the-mouth lymphatics drained through the periosteum prior to entering the cervical lymphatic chain.

Animals↗
PubMedDate not supplied

Steel bar penetrating the skull.

A 42-year-old construction worker was struck in the head by a ten-foot steel bar that fell 240 feet, entering the left parietal area of the skull and exiting above the left zygoma. The bar was surgically removed and the postoperative course was unremarkable. His residual deficits include mild aphasia and the need of a cane for assistance with walking.

Adult↗