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Biomedical subjects

I T Jackson

Publications and source records attributed to I T Jackson.

At least 73 records · Page 4Linked to original sources
PubMed1995

Midface advancement in sheep by gradual distraction: a 1-year follow-up study.

PURPOSE: The purpose of this study was to find a solution to the unsatisfactory postoperative maxillary relapse after major maxillary advancement or inferior repositioning of the maxilla. MATERIALS AND METHODS: Major midface advancement by gradual distraction was performed on three young adult sheep over 21 days. Using an external device, the midface was advanced 36 mm in the nasofrontal area and 43 mm in the lateral aspect of the maxilla. The apparatus remained as an external fixation device for 6 weeks after the distraction to allow better ossification. After removal of the device, a 1-year clinical and radiographic follow-up was conducted. RESULTS: Direct measurements between the markers showed 2- to 3-mm relapse after 1 year. Radiologic measurements demonstrated that the relapse occurred during the first 3 months after removal of the distraction apparatus. CONCLUSION: It was concluded that midface advancement by gradual distraction may obviate the need for bone grafting and offer a greater movement of bone segments with good skeletal stability.

Animals↗
PubMed1995

Significant hemangiomas and vascular malformations of the head and neck: clinical management and treatment outcomes.

The treatment dilemmas and our institutional experience with head and neck hemangiomas and vascular malformations are reviewed. Fifty-eight patients (38 with hemangiomas, 20 with vascular malformations) aged from newborn to 78 years were treated from 1975 to 1993. Eighty-seven percent of patients provided up-to-date follow-up, yielding a median follow-up interval of 7.18 years from intervention. Only significantly sized tumors (minimum diameter > 4 cm) were studied. Sodium tetradecyl sulfate sclerotherapy (SDS) was a sole therapy in 12 patients (all with hemangiomas) and was used in combination with surgical ablation in 22 patients (16 with hemangiomas, 6 with vascular malformations). The minority of tumors from both categories were completely removed with ablative surgery (six hemangiomas [23%], eight vascular malformations [44%]). Significantly debilitating tumor postsurgical recurrence, which led to mortality in some patients, was unique to vascular malformations with high flow on the basis of increased arterial to venous shunting. Less alarming but significant functional and cosmetic challenges are created in primarily postadolescent patients with incompletely involuted hemangiomas and low-flow vascular malformations of the head and neck. We have had a favorable experience with the combined application of sclerotherapy and conservative ablative surgery in this group. Patient survey implied satisfaction with treatment in the majority: Nine indicated they benefited significantly (17%); 37 indicated they were generally improved (71%); and 6 stated they did not benefit (12%). Tumor-specific philosophy on ablative therapy, recurrence patterns, and associated complications are presented.

Adolescent↗
PubMed1995

Management considerations for the granuloma of pregnancy.

The epulis gravidarum, or granuloma of pregnancy, represents a vascular lesion observed during gravidism. While histologic features may mimic those of generic pyogenic granulomas, the management may differ. Remarkably, the plastic surgical literature is conspicuously void of information concerning this common entity, with approximately 40 new cases being diagnosed and treated annually at our institution. With a review of the literature, we offer four typical and representative case reports that serve to highlight the pertinent physiology and treatment options. Guidelines are proposed to assist in the management of this disease process.

Adult↗
PubMed1995

Neurofibromatosis of the skull base.

Neurofibromatosis of the skull base is a syndrome that may occur in an isolated fashion or as a component of Von Recklinghausen disease. This article discusses the clinical features of neurofibromatosis, diagnostic methods, and surgical treatment.

Adult↗
PubMed1994

Toxic shock syndrome associated with suction-assisted lipectomy.

Toxic shock syndrome (TSS) is a serious, potentially life-threatening condition resulting from an exotoxin of Staphylococcus aureus. Presenting symptoms include high fever, diarrhea, nausea, and vomiting progressing to hypotension, oliguria, conjunctival hyperemia, and an erythematous rash over the trunk, abdomen, and extremities. TSS has been associated both with and without the use of tampons during menstruation, postsurgical infections, and stab wounds, and can occur in postrhinoplasty patients with and without nasal packing. There has been one case reported in the literature of TSS associated with suction-assisted lipectomy (SAL). This article discusses the diagnosis and treatment of two cases in which the patients developed TSS after outpatient use of SAL. In the first case, an abdominoplasty and SAL were performed in a healthy young female. The second case involved the harvesting of abdominal fat via syringe suction and subsequent facial fat injection in a female with systemic lupus erythematosus and severe facial atrophy.

Adult↗
PubMed1994

Role of perivenous areolar tissue and recipient bed in the viability of venous flaps in the rabbit ear model.

This study was performed to investigate the role of perivenous areolar tissue and flap bed in the viability of venous flaps in the rabbit ear model as described by Inada et al. Six groups of flaps were studied: group A--flap based on a proximal vein and areolar tissue; group B--flap based on a proximal venous pedicle which has been skeletonised; group C--flaps based on a proximal vein and areolar tissue sutured over a full thickness skin graft (FTSG), preventing diffusion into the flap; group D--flaps with a skeletonised pedicle sutured over a FTSG; group E--control, non-vascularised flap placed directly on bed; and Group F--control, non-vascularised flap sutured over a FTSG. Groups C and D had 15 flaps and the remaining groups had 10 flaps in each. All flaps in groups A and B had total or partial survival. In group C 4 flaps survived completely, 8 had partial survival and 3 necrosed. Group D had only 2 flaps with partial survival with 13 flaps with total loss. In group E there were 10 flaps with partial survival and none with complete loss. No flaps in group F survived. Histological examination of the pedicle showed small vascular channels present in the areolar tissue surrounding the venous pedicle. This study confirms the importance of the perivenous areolar tissue in the perfusion of the venous skin flap in the rabbit ear model.

Animals↗
PubMed1994

Extradural dead space following cranial bone advancement.

The extradural dead space produced after enlargement of the intracranial space or after reduction of the volume of the intracranial contents persists for an unknown period of time. To investigate this further, an extradural dead space was surgically created by advancement of parietal bones in 9 adult rabbits. By design, there was no connection with the paranasal sinuses. To determine outcome of the dead space, three-dimensional computed tomographic and histological studies were performed. The brain volume decreased in the first 3 months after surgery and remained constant for up to 9 months. The extradural volume increased in the first 4 weeks postoperatively, gradually decreasing in size with time. The brain failed to eliminate the extradural dead space by rearrangement or expansion. An osseous cavity filled with fluid and connective tissue was formed within the dead space. The fluid within it remained, even 9 months after surgery. This could be a potential environment for bacterial invasion if there was a connection with the nasopharynx.

Animals↗
PubMed1994

A comprehensive analysis of craniofacial trauma.

A review of the literature identified a need for a prospective study of the complete range of craniofacial trauma. The aims of this study were to determine the incidence, etiology, and mechanisms of craniofacial and associated injuries, enabling a greater understanding of their range and magnitude. Nine hundred fifty consecutive patients seen at an urban university hospital with any degree of craniofacial trauma were prospectively investigated. Craniofacial trauma was found to be very common at all ages. The causes were directly related to age, sex, and alcohol consumption, and determine the type and severity of injury. The commonest cause of soft-tissue injury was falls, whereas that of fractures was interpersonal violence. Falls accounted for most of the injuries in children and the elderly, whereas interpersonal violence was mainly responsible for those occurring in patients aged 15 to 50 years. Interpersonal violence mostly involved young male adults: fights occurring mainly between strangers who had consumed excessive amounts of alcohol. Women were usually assaulted by assailants known to them, their partners. Pedestrians showed a propensity to sustain cranial fractures, whereas motor vehicle occupants tended to sustain midfacial fractures and bicyclists mandibular fractures. Pedestrians incurred the severest injuries of all road users, and a significant proportion of road user collisions involved bicyclists. Sports were responsible for a significant proportion of craniofacial injuries in youths and young adults. Craniofacial soft-tissue injuries overall occurred most frequently on the forehead, nose, lips, and chin, and a method for their classification is proposed. The commonest craniofacial fracture was that of the nasal bones (45%), followed by cranial bones (24%), mandible (13%), zygoma (13%), orbital blow-out (3%), and maxilla (2%). The incidence of craniofacial trauma can be greatly reduced by improvements in interior home design, school education in alcohol abuse and handling potentially hostile situations (especially for men), improvement in automotive safety devices and compliance by motor vehicle occupants, and utilization of full-face helmets by bicyclists and motorcyclists.

Accidental Falls↗
PubMed1994

A cadaver investigation of the blood supply of the galeal frontalis flap.

The vascular anatomy of the galeal frontalis flap was studied in 12 fresh cadavers by an intraarterial dye injection technique. Special attention was directed to the length limit of this flap. The general belief that the galeal frontalis flap has a robust vascularity by means of the supratrochlear and supraorbital arteries was not demonstrated in this study. In the medial half of the forehead, superficial branches of both arteries penetrated the frontalis muscle immediately above the supraorbital rim and ran superficially in the subcutaneous tissue. In the lateral half, some of the superficial branches of the supraorbital artery traveled with the frontalis muscle and anastomosed with the frontal branch of the superficial temporal artery. Deep branches of the supratrochlear and supraorbital arteries showed an axial distribution on the periosteum only for a short distance. One or two branches of the supraorbital artery were found to take a superficial course within the subgaleal layer, pierce the frontalis muscle, and anastomose with the superficial temporal artery. These findings suggest that the galeal frontalis flap should be elevated in the lateral forehead. The preservation of the periosteum with the flap is recommended in order to ensure the temporoparietal extension.

Blood Vessels↗
PubMed1994

Anatomy and significance of the temporal fat pad in Apert syndrome.

Abnormal temporal region anatomy in Apert syndrome described in the literature includes inferior and lateral displacement of the middle cranial fossa, effacement of the temporal fossa, and thinning of the temporalis muscle. Four patients with Apert syndrome were noted to have hyperplasia of the bilateral superficial temporal fat pads, which could be contoured surgically. A case is presented with reformatted three-dimensional computed tomography (3-D CT) scans with intraoperative documentation of increased temporal fat as compared to normal controls.

Acrocephalosyndactylia↗
PubMed1994

Craniofacial tumors.

The management of craniofacial tumors is presented, beginning with a discussion of terminology and anatomy. The importance of imaging is stressed. The significance of the internal carotid artery and an investigation of cerebral artery supply also are given. The most significant advances in the treatment of these tumors have been the soft-tissue approaches, but methods of disassembling the bony face for the ultimate in exposure are also important. Free tissue transfer has been a great advance in reconstruction and prevention of infection and in giving some patients a second chance for further radiation. With the application of newer techniques of exposure and resection, together with vascularized reconstruction, the prognosis from these tumors has improved and the complications have been reduced.

Adult↗
PubMed1994

Arteriovenous fistula formation after punch graft hair transplantation in the frontal region.

A case of arteriovenous fistula formation following punch hair grafting is presented. This is indeed a potential complication of a hair plug transplantation procedure in both recipient and donor sites. Surgical excision of the fistula in the frontal or midline scalp region requires resection of the overlying skin because the involved vessels lie within the subdermal plexus.

Adult↗
PubMed1993

Orbital neurofibromatosis with enophthalmos.

Two patients with orbital neurofibromatosis associated with enophthalmos are presented. Assessment using 3D-CT scan shows an increase in the size of the orbital cavity and an enlargement of the inferior orbital fissure, which allows orbital fat to prolapse into the infratemporal fossa, causing enophthalmos.

Adult↗
PubMed1993

Midface advancement by gradual distraction.

Midface osteotomy was performed on 5 young adult sheep aged 10-12 months. In 4 animals midface advancement by gradual distraction was performed using an external device; one animal served as a control. The midface was advanced by 2 mm per day for 21 days. The amount of advancement was 36 mm in the nasofrontal area and 43 mm on the lateral aspect of the maxilla. After the period of active distraction the midface was maintained with external fixation for an additional 6 weeks to allow for ossification. Radiographs were obtained immediately postoperatively, after 21 days of distraction, and at the end of the 6 week fixation period. New bone formation in the distracted area was obvious radiographically, clinically and histologically. In conclusion, midface advancement by osteotomy and gradual distraction is possible in the sheep model and may offer controlled correction of deformity, obviating the need for the bone grafting.

Animals↗
PubMed1993

Penetration of the skull base by dissecting keratocyst.

The extensive destructive potential of the keratocyst has been well recognized but penetration of the keratocyst into the skull base is rare. 3 cases showing such aggressive behavior and rare location were seen and treated; 2 are reported in this paper. Both cases illustrate the importance of early radical treatment once the aggressive nature of keratocyst is recognized.

Female↗