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Biomedical subjects

I Eliachar

Publications and source records attributed to I Eliachar.

At least 73 records · Page 4Linked to original sources
PubMed1986

The rotary door myocutaneous flap. A reliable technique for laryngotracheal reconstruction.

We examined the possible uses of the "rotary door" sternohyoid myocutaneous flap (RDF) in laryngotracheal reconstruction. This well-vascularized myocutaneous flap, when rotated axially, can replace or widen the anterolateral walls of the airway. It provides a large epithelial surface, together with bulky structural support. The flap is readily available within the immediate surgical field and can replace large defects in the airway, from the level of the glottis to the cervical trachea. After extensive structural and soft-tissue loss of the larynx and trachea were produced to simulate commonly encountered traumatic and postsurgical stenotic conditions, the RDF was employed in 23 dogs in a single-stage laryngotracheal reconstruction. A stable, widely patent airway was achieved. The dogs were followed up for periods varying from three to six months. No complications or secondary stenoses were encountered. Photographic, radiologic, and endoscopic examinations demonstrated the viability and usefulness of this newly described flap. Long-term tracheostomy was used so that intraluminal stents and cannulas could be avoided. Histopathologic studies confirmed the integration of the RDF into the framework of the larynx and trachea. Application of this technique in cases of tumors, trauma, and stenosis of the airway is suggested.

Airway Resistance↗
PubMed1986

Auditory brain-stem evoked potentials in patients undergoing dialysis.

Auditory brain-stem evoked potentials (ABEPs) and pure-tone audiograms were obtained for 38 patients with renal failure, undergoing dialysis, before and after a dialysis session, and for 40 healthy normal subjects. Blood chemistry was also evaluated for each patient before and after dialysis. ABEP abnormality (using 10/sec click rate) was observed for 24% of the patients, rising to 44% when 55/sec measures were included. Abnormalities included prolongations of peak latencies for both click rates, and prolongation of interpeak latency differences. Pre-dialysis calcium was significantly different between patients with or without ABEP abnormality. In addition to this chronic effect on ABEPs, an acute effect of the dialysis session was found. Blood chemistry data, ABEP latencies and I-III interpeak latency differences were significantly different before, as compared to after dialysis. The acute effect of dialysis on blood calcium levels correlated with its effect on latencies of peaks III and V at 10/sec click rate, and on peaks I and V latency at 55/sec. These results may indicate the types of dysfunction revealed by increased stimulus rate measures.

Auditory Perception↗
PubMed1986

A modified technique for tubeless tracheostomy.

The dog is an animal widely used in experiments, and tracheostomy is frequently necessary when laryngeal experiments are carried out. Unfortunately, dogs generally do not tolerate tracheostomy well because the inserted cannula easily becomes displaced or blocked. This article presents a new surgical technique aimed at providing a long-term, dependable, and safe airway. It is based on previously established, clinically tested principles to avoid local tracheal complications. No essential tissue is removed or irreparably damaged and the procedure is reversible. Flexibility in management of the resultant stoma is possible, allowing either maintenance of maximal patency or gradual closure. Twenty-one animals were studied for 3- and 6-month periods, and there was no morbidity because of airway obstruction. This technique can reduce loss of valuable experimental animals caused by airway complications. It may also have application in human beings.

Animals↗
PubMed1986

Combined rotary door flap and epiglottic laryngoplasty for reconstruction of large laryngotracheal defects in dogs.

Reconstruction of large laryngotracheal defects may require simultaneous application of more than one surgical technique. This paper reports the advantages gained by combining epiglottic laryngoplasty with the myocutaneous sternohyoid muscle rotary door flap. The two procedures complement each other in achieving structural and functional rehabilitation of extensive defects in the larynx and trachea. Avoidance of intraluminal stents and use of a tracheostomy procedure that does not require an indwelling cannula have yielded improved results.

Animals↗
PubMed1985

Near-total pharyngeal reconstruction by 'rotary-door' sternohyoid myocutaneous flap in the dog. A preliminary report.

Closure of the pharyngoesophagus after total laryngectomy or partial pharyngectomy is not a difficult problem in most cases. Primary suture repair of the defect is usually adequate, providing sufficient healthy mucosa is available. When this is not feasible, it may be necessary to mobilize tissue from distant sites. The deltopectoral and various myocutaneous flaps are often chosen for this purpose because of their reliability and versatility. Unfortunately, they necessitate either two-stage surgery or involve excessive bulk, and both methods result in unsightly defects, especially in women. The "rotary-door" sternohyoid myocutaneous flap avoids these drawbacks, while utilizing tissues within the surgical field in a single-stage procedure. Seven mongrel dogs underwent total laryngectomy and partial pharyngectomy. The pharyngeal defect was closed with a rotary-door sternohyoid myocutaneous flap. Three dogs had an uneventful recovery and two developed fistulae that closed spontaneously within three weeks of surgery. The pharyngocutaneous repair was found to be intact on postmortem examination.

Animals↗
PubMed1985

Familial combined hyperlipidemia and otosclerosis--the occurrence in a large kindred.

The occurrence of otosclerosis and hyperlipidemia in four generations of a single family is described. The lipid abnormality fulfilled the characteristics of combined familial hyperlipidemia. Whereas a genetic linkage between combined hyperlipidemia and otosclerosis is feasible, our study indicates that both conditions are inherited through autosomal but unlinked genes.

Adolescent↗
PubMed1985

Histologic changes in skin implanted into the larynx and trachea by myocutaneous flap reconstruction.

Skin is the tissue most readily available for relining the walls of the reconstructed larynx or trachea. Its use has been condemned in the past because of potential contracture, complications have occurred when free, split-thickness grafts were used. We studied the changes that develop within skin that is transferred into the lumen of the airway as part of a vascularized sternohyoid myocutaneous flap. Twenty-one dogs underwent reconstruction of laryngotracheal defects by a vascularized myocutaneous flap. The closely shaved and chemically depilated skin included in this reconstruction was ultimately found to be well healed to the adjacent mucosa. Flaps as large as 8 cm2 survived with no evidence of scaling, crusting, or contracture. The cutaneous appendages in the flaps were compared with those found in adjacent skin near the donor site. After proper depilation there was involution of cutaneous appendages. Scarring of the dermis appeared to add support to the grafts. Our findings demonstrate that the rotary door sternohyoid myocutaneous flap is a reliable, well-vascularized flap that can have extensive application in laryngotracheal reconstruction.

Animals↗
PubMed1985

Prolonged ventilation of the middle ear and mastoid cavities: technical considerations.

Chronic eustachian tube dysfunction contributes to many chronic middle ear diseases and to early and late surgical failures. Furthermore, surgeons may overlook air passage obstructions from the mesotympanum to the mastoid cavity. To date, long-term ventilation of the middle ear is the most practical technique of bypassing stubborn eustachian tube and middle ear ventilatory malfunctions. I present the techniques used to overcome and bypass tubal and intratympanic obstructions in 8% of operated ears in the past 6 years.

Ear Diseases↗
PubMed1984

Rotary-door flap in laryngotracheal reconstruction.

A newly described vascularized myocutaneous flap based on the infrahyoid muscles is presented. The blood supply originating at the superior and inferior thyroid arteries is preserved. This flap is rotated axially, 180 degrees, to augment and resurface the lumen of the stenosed airway. Stenting is achieved by means of a silicone T tube topped by a custom-carved laryngeal stent. Hyoid transposition may be included when required. We successfully reconstructed 15 cases of laryngotracheal stenosis by this method. The regional flap provides a dependable, readily applicable technique for reconstruction of difficult laryngotracheal stenoses.

Adolescent↗
PubMed1984

Arterial blood supply to the infrahyoid muscles: an anatomical study.

The arterial supply to the infrahyoid strap muscles originating from the superior thyroid artery (STA), the inferior thyroid artery (ITA), and the internal mammary artery (IMA), also called the internal thoracic artery, were investigated. Intraarterial silicone dye was injected into eight fresh cadavers followed by dissections. The blood supply to the infrahyoid muscles was found to be segmented in nature with the dividing line at the level of the cricoid ring. No axial pattern of vascularization could be demonstrated within the strap muscles. The skin overlying these muscles is supplied by tributaries arising from the above-described arteries. Application of the information gathered is discussed in consideration of local myocutaneous and myoosseous flaps for reconstructive surgery, particularly of the larynx and trachea.

Arteries↗
PubMed1984

Permanent tracheostomy.

A technique designed to create a permanent, wide open, and stable tracheal stoma is based on two corresponding U-shaped flaps: one from the anterior tracheal wall, the other from the skin in the suprasternal notch. The method described in this article has proved to be efficient, practical, well tolerated, and readily reversible. Its applications when indicated may reduce the side effects and complications associated with tracheostomy. Our clinical experience with this technique covers eight patients who tolerated the procedure well. The follow-up period exceeds 2 years.

Adult↗
PubMed1984

Blood supply and innervation of the supermedial thigh flap employed in one-stage reconstruction of the scrotum and vulva--an anatomical study.

The supermedial thigh flap is an arterial and sensate flap. Anatomical studies reveal both large and small nutrient arteries. Its largest and most consistent artery is the superficial branch of the deep external pudendal artery, which constitutes the main circulation. The secondary blood supply to the base of the flaps is contributed by musculocutaneous perforators of the medial circumflex femoral artery. Subcutaneous branches of the superficial femoral artery, when present, are an additional source of arterial supply. Branches of the ilioinguinal nerve provide sensory innervation to the flaps.

Arteries↗
PubMed1984

Measurement of the laser exposure levels for burn threshold in biological tissue.

Experiments for the evaluation of the laser energy density required to induce burn threshold in biological tissue are presented. The results are compared with a theoretical model. The values obtained for soft tissue are higher than the pain threshold and the safety standards for the maximum permissible exposure. This is due to the different nature of injury associated with the surgical process.

Biomedical Engineering↗
PubMed1984

Transstomal endoscopic monitoring of patients managed by tracheal silicone T-tubes.

Transstomal preoperative endoscopic examination (using rigid Hopkins type telescopes) of patients considered for surgical repair or stenting of laryngotracheal stenosis is described. This technique is further employed in patients managed with silicone T-tubes to monitor the airway during the stenting period and to determine the timing for removal of the tubes. Immediate post-removal endoscopic follow-up is most valuable in determining the patency and stability of the newly reconstructed airway.

Endoscopy↗
PubMed1983

Verification of impedance measurements by a volumetric and electromechanical model.

A dynamic model of the middle ear and mastoid cavity will be presented. A variety of precisely controlled volumetric changes were simulated by the model, singularly or in conjunction with pressure changes, mass and friction effects at the level of the drum. The contributions of each factor alone and in controlled combinations to the acoustic impedance were serially tested and recorded. The validity of static compliance and tympanometry in volumetric middle ear and mastoid estimates is questioned. The model demonstrated dependability of impedance tympanometric techniques in measuring intratympanic air fluid contents and pressure changes. The model provided objective evidence on the capability of impedance techniques to differentiate mechanical traction on the drum from traction brought about by negative pressures. Clinical applications of these findings will be discussed.

Acoustic Impedance Tests↗