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Biomedical subjects

I R Munro

Publications and source records attributed to I R Munro.

83 records · Page 5Linked to original sources
PubMed1975

The anesthetic management and intraoperative care of patients undergoing major facial osteotomies.

Our experiences with 42 major craniofacial osteotomies--performed at The Hospital for Sick Children, Toronto, between July, 1971 and January, 1974--are related. Guidelines for operative care and anesthetic management are outlined--with regard to the length and positioning of endotracheal tubes, fluid and blood replacement, reduction of intracranial pressure, prevention of pressure necrosis, and postoperative airway care. Adherence to these principles and cooperative teamwork may prevent unexpected deaths or complications, and may minimize morbidity.

Adolescent↗
PubMed1975

Lymphangioma. A long-term follow-up study.

At the Hospital for Sick Children 177 patients with lymphangioma, exclusive of those who had intra-abdominal lesions, were seen between 1927 and 1964. Forty-nine of these (aged 8 to 41 years) were available for follow-up examination. The results of treatment by surgical excision, aspiration, incision and drainage, and radiation are reported. No cases confirmed histologically as lymphangioma underwent spontaneous regression. Two histologically unconfirmed cases underwent partial regression. Four of the 11 who were left with lymphangioma tissue at operation never had significant recurrences. Therefore, this clinical study does not clarify the possible role of spontaneous regression in lymphangioma. Extensive surgery is the treatment of choice whenever feasible, but in unilocular or bilocular cystic lymphagnioma subsequent regression can be expected after palliative treatment (aspiration, or incision and drainage). Clinical and pathological criteria should be established for differentiation between lymphangioma and primary lymphedema. Lesions involving subepithelial, subdermal, and subcutaneous or internodal networks of lymphatics will produce lymphagioma; lesions of the collecting lymphatic trunks will result in lymphedema.

Abdominal Neoplasms↗
PubMed1975

Lymphedema. A clinical review and follow-up study.

In a retrospective study of primary lymphedema, we found that the age of onset ranged from 0 to 16 years; sex did not appear to be a factor; and treatment was preventive rather than surgical. Thirteen patients were available for follow-up studies, the time interval being at least 6 years. The degree of swelling at the time of the follow-up examination was defined as mild, moderate, or severe. In patients with mild and moderate swelling the edema was not progressive and surgical treatment was not indicated. Severe swelling appeared to be associated with congenital lymphedema and with repeated infection. Pressure-support treatment can be effective in the reduction of swelling or in the prevention of further swelling, if applied constantly over a long period of time. The authors discuss the histological similarity between lymphedema and lymphagioma, and present an anatomical classification for the two entities.

Adolescent↗
PubMed1975

Difficulties and problems to be solved in the approach to craniofacial malformations.

Orbitocraniofacial surgery offers great possibilities to some grossly deformed patients. It is unlike any other aspect of plastic surgery, meriting the creation of a new full-time specialty. The development of a few regional clinical basic science teams located strategically throughout North America is suggested. The primary aim of the teams should be a broad interdisciplinary approach involving basic and clinical research focused on craniofacial anomalies. However, to bring all the necessary multidisciplinary groups into an interdisciplinary team requires central funding to make available the necessary commitment of time to organize a unified thrust of research effort.

Craniofacial Dysostosis↗
PubMedDate not supplied

Long-term effects of orbital irradiation.

This retrospective study is a review of 18 patients who received radiotherapy to the orbit between the ages of 1 month and 10 years. Patients were followed for 7-21 years in an attempt to define the effects of orbital irradiation on a growing child. None of the patients in the study was spared injurious effects on soft tissue or bone, but soft tissue appeared to be more vulnerable to radiation than bone. Orbital irradiation caused soft tissue deficits of the upper face in 100% of the patients. Sixty-seven percent of patients had soft tissue deformities of the midface, and 13% had soft tissue deformities of the lower face. Bony deficits were found in the upper face in 67% of the patients, the midface in 50%, and the lower face in 6%. This study found no correlation between age and time of radiotherapy on the effects of facial growth.

Adolescent↗
PubMedDate not supplied

Surgical management of unilateral and bilateral coronal craniosynostosis: 21 years of experience.

From 1955 to 1975, 116 patients with unilateral and bilateral coronal synostosis, including 39 with craniofacial dysmorphism, were treated surgically. Five techniques were used: multiple linear craniectomies, linear craniectomies with supraorbital grafting, morcellation craniotomies, lateral canthal advancement of the supraorbital margin, and radical cranio-orbitofacial reconstruction. Analysis of clinical and radiological indices of the synostotic process, coupled with evaluation of the surgical results, indicates that the anterior skull base is the site of origin of the bony dysplasia. Therefore, early creation of artificial sutures in the skull base is recommended to provide adequate expansion of the frontal bones and consequently of the entire facial skeleton.

Adolescent↗