Search PubMed⌕ Search

Biomedical subjects

I T Jackson

Publications and source records attributed to I T Jackson.

At least 181 records · Page 10Linked to original sources
PubMed1985

Craniofacial approach to tumors of the head and neck.

The type of surgery described in this article is safe and effective when performed by an experienced team of plastic surgeons and neurosurgeons. In a very extensive series of patients with tumors of the cranial base, there has been only one surgical death. It occurred the day after surgery and was thought to have resulted from an error in administering anesthesia. Reconstruction is limited in patients with malignant disease, especially when the tumor is recurrent after radiation therapy. It is better to delay and not hide any area of potential recurrence. Reconstruction can be performed at 12 to 18 months. In nonmalignant tumors, total reconstruction is performed. Extensive surgery can be carried out with a good chance of cure. Initial rehabilitation is with a prosthesis, but later reconstruction will give an acceptable result. Thus, both surgeon and patient may embark on this hazardous course with a much greater degree of security and equanimity.

Cranial Fossa, Posterior↗
PubMed1985

Esthesioneuroblastoma: treatment of skull-base recurrence.

Thirty-nine patients with esthesioneuroblastoma are reviewed. The presentation of the tumor, symptomatology, investigation, and treatment are discussed. A recommended treatment regimen is outlined. Histologic typing is valueless in predicting tumor behavior. An illustrative and difficult case of recurrent base of skull esthesioneuroblastoma is presented. The resection performed is described, and the problem of extradural oropharyngeal communication is discussed. The solution was to use a temporalis and galeal frontalis flap. Reconstruction was with an external and intraoral prosthesis. Optimal treatment in a fresh lesion is radical surgery with or without radiation therapy. Esthesioneuroblastoma is a rare and often misdiagnosed malignant tumor of the olfactory epithelium. Originally described by Bergen et al. in 1924 as "esthesioneuroepithelioma olfactif," it was introduced into the North American literature by Schall and Lineback in 1951. Since then, fewer than 200 cases have been collected. The various terms used to describe it--olfactory esthesioneuroblastoma, esthesioneurocytoma, and olfactory neuroblastoma--all denote origin from the neural crest. The sensory nerves of smell are short bundles of fibers that originate in the olfactory bulb and pass through the cribriform plate to the olfactory area of the nasal mucosa. This mucosa is located in the most superior part of both nasal fossae. Thus the usual primary sites of occurrence include the superior nasal cavity or nasal septum, and turbinates, the ethmoid, or the cribriform plate, although an extranasal site of origin has been suggested. Symptoms are usually progressive and range from nasal obstruction or epistaxis to diplopia, ocular pain, and headaches in the more advanced disease state.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1983

Anesthesia for craniofacial osteotomies.

Management of major craniofacial deformities requires an interdisciplinary approach. The importance of the role of the anesthesiologist is often not appreciated by those outside that specialty. The experience of almost fifteen years of dealing with these very difficult cases is presented. Anesthetic techniques are discussed in general terms. Intraoperative and postoperative airway problems and solutions are stressed. An effort is made to describe how the anesthesiologist should work with the surgeon to prevent anesthetic emergencies and to ensure optimal patient management.

Anesthesia↗
PubMed1983

Anterior cranial fossa tumors.

The anterior cranial fossa may be invaded by malignant or nonmalignant tumors arising in the orbit, orbital contents, nose, nasopharynx, or frontal, ethmoid, or sphenoid sinuses. Skin and maxillary tumors can also spread to the skull base. One must be aware of this and assess the situation with the neurosurgeon, and use coronal and axial CAT scans. The approach is intracranial and extracranial, with total en bloc tumor resection under frozen section control. In nonmalignant tumors immediate reconstruction is performed; in malignant tumors, especially recurrent ones, the reconstruction is delayed twelve to eighteen months to lessen the chances of later recurrences. With this approach, recurrences have been few and survival rates excellent, even in advanced recurrent lesions.

Carcinoma, Squamous Cell↗
PubMed1983

Frontonasal encephalocele--"long nose hypertelorism".

Two varieties of frontonasal encephalocele are presented, with variations in the surgical technique necessitated by the different anatomical findings. The encephalocele pushes the nasal skeleton posteriorly and caudally and widens the distance between the medial orbital walls. This causes the long nose and the telecanthus. In this variety of frontonasal encephalocele, hypertelorism is uncommon. There may be absence of dura in relation to the encephalocele. The suggested method of correcting the deformity involves a combined intracranial and extracranial approach. The nasal skeleton is mobilized and placed in its correct position and the telecanthus is corrected. All skull defects are bone grafted. Correcting the deformity at an early age is recommended.

Child↗
PubMed1983

The skull as a bone graft donor site.

Three techniques are described for obtaining bone grafts from the skull for the correction of craniofacial defects. The advantages over the traditional methods of obtaining bone grafts are discussed. A total of 64 patients have undergone reconstruction of deformities and defects resulting from congenital anomalies, acute trauma, sequelae of trauma, tumor resection, and radiotherapy. Apart from 1 case of wound infection, there have been no functional or cosmetic problems.

Adult↗
PubMed1983

Nasal bone grafting using split skull grafts.

The nose has been reconstructed with bone grafts, cartilage, and silicone. Each of these methods has disadvantages, but the bone graft is most trouble free. It is possible to take a split skull graft with a high speed drill and an osteotome. The position of the graft site on the skull determines its shape. This can be tailored to the desired nasal contour. Several grafts may be used to build up the nasal dorsum further. This method has been used in patients suffering from acute trauma and deformities resulting from previous trauma, rhinoplasty, congenital anomalies, and after cancer resection. Apart from 1 scalp wound infection, there have been no complications in 24 cases. The degree of bone graft resorption has been minimal, and the level of patient satisfaction has been high.

Adult↗
PubMed1983

The surgical management of orbital neurofibromatosis.

Orbitofacial neurofibromatosis may cause severe soft-tissue deformity along with pulsating exophthalmos. The orbit is enlarged, and the greater wing of the sphenoid is absent. The eye in some cases may be functionally useless, immobile, displaced, and blind. In these, orbital exenteration with soft-tissue excision and orbital reconstruction is recommended. External cover is provided by the thin eyelid skin, and a prosthesis ultimately allows a very satisfactory end result. Four such cases with a minimum of 2 years of follow-up are presented.

Adolescent↗
PubMed1983

Primary veloplasty or primary palatoplasty: some preliminary findings.

Staged palatal closure was carried out in 30 children. The soft palate was closed at 9 months and the hard palate at 5 years. These patients were followed up for 7 years, and it was found that although the incidence of lateral crossbite was reduced in both unilateral and bilateral cases, the speech results were less satisfactory than those obtained with total palatal closure. In this series, there were two fistulae at the junction of the hard and soft palate. This was related to difficulty in closing this area in some patients at the time of the second operation. As a result, the procedure is not advised. An alternative palatal closure technique is described. This technique consists of nasal layer closure, careful dissection and reconstruction of the levator musculature, transverse division of the nasal layer, insertion of a buccal flap for lengthening, and closure of the oral layer with Veau flaps without dissection behind the tuberosities and with almost total closure of the lateral donor sites on the palatal shelves. In this way there is minimal scarring, particularly in the retrotuberosity area. This is felt to be important since it would seem from studies of facial growth that this is a much more significant area than the palatal shelves.

Child, Preschool↗
PubMed1983

Multifocal Merkel's cell tumors associated with a cutaneous dysplasia syndrome.

Multifocal Merkel's cell tumors developed in a 24-year-old patient with an unusual cutaneous dysplasia syndrome. The neoplasms behaved in an aggressive fashion, with the development of multiple lymph node metastases. In this case, the dermatologic syndrome had features of both dyshidrotic ectodermal dysplasia and the basal cell nevus syndrome. In addition to Merkel's cell tumors, basal cell carcinomas and actinic elastosis were seen in sun-exposed skin sites. These findings, in conjunction with a known tendency for Merkel's cell tumors to arise in solar-damaged areas, suggest a pathogenetic relationship between these neoplasms and the underlying cutaneous syndrome in this patient.

Adenocarcinoma↗
PubMed1982

Muscle and myocutaneous flaps on the lower limb.

Defects of the lower limb can be repaired in several ways and a very satisfactory closure can be obtained using muscular and myocutaneous flaps. The soleus muscle, both heads of the gastrocnemius muscle, the peroneus brevis muscle and the flexor hallucis longus muscle can all be used, the choice depending on the site of the defect.

Adolescent↗
PubMed1982

Bone grafting of the secondary cleft lip and palate deformity.

A series of 112 cases of bone grafting in secondary cleft lip and palate deformities is presented with a follow-up averaging 7.5 years. The orthodontic management of these patients is described. The advantages of this procedure, in terms of secure fistula closure, maxillary stability, ease of subsequent orthodontic and prosthodontic management and the benefits from an aesthetic point of view are analysed and their relevance in total patient management discussed.

Adolescent↗
PubMed1982

A systematic approach to tumours of the base of the skull.

The base of the skull can be divided into three segments. This division allows a better understanding of the spread and the symptoms related to tumours in this area. Based on the location of the tumour, the surgical approach is varied. This systematic consideration allows for more efficient exploration of this difficult area by a combined plastic and neurosurgical approach. The types of tumours occurring in this area and their prognosis are discussed. A pre-existing craniofacial team experienced in the management of congenital craniofacial anomalies is an advantage when this type of procedure is done.

Diagnosis, Differential↗