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Biomedical subjects

J C Cruickshank

Publications and source records attributed to J C Cruickshank.

9 recordsLinked to original sources

Office sedation.

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Ambulatory Surgical Procedures↗

Strangulation of the uvula by hair wrapping.

A 13-month-old male presented with a hair wrapped around his uvula. The entwined hair subsequently caused autoamputation of the distal uvula. Although a non-accidental etiology has been suggested for some cases of hair strangulation of appendages, this case indicates accidental strangulation of body parts is possible.

Amputation, Traumatic↗

Treatment of stage I carcinoma of the anterior floor of the mouth.

A retrospective study of 27 patients treated for stage I squamous cell carcinoma of the floor of the mouth was performed to assess the effectiveness of therapy. Of these patients, 23 (85%) underwent surgical therapy. Four patients (15%) were treated with radiation therapy alone, and three (11%) underwent combined surgery and radiation treatment. Initial treatment failed in seven patients (26%), and further therapy was curative in only four of seven. This small study suggests that stage I floor-of-the-mouth squamous cell carcinoma is not an easy lesion to cure. Other studies support these data. A three-dimensional monobloc resection with a 2-cm margin, including resection of the submandibular glands, is advocated. Toluidine blue O mucosal staining and Mohs' chemosurgery are helpful adjuncts in determining the tumor margins.

Adult↗

Cricothyroidotomy for long-term tracheal access. A prospective analysis of morbidity and mortality in 76 patients.

Cricothyroidotomy for long-term tracheal access was prospectively studied in 76 critically ill patients. Thirty patients (39%) survived and 46 (61%) died. Mean duration of follow-up computed in all survivors was 8.5 months. Postmortem examination of the airway was performed in 85% of the nonsurvivors. Five patients (7%) had major complications including one death, subglottic stenosis in two adolescent patients, reversible subglottic granulation with partial obstruction in one patient, and tracheomalacia in one patient. Minor complications occurred in 23 (30%) survivors. Eleven (28%) of the nonsurvivors examined post mortem had airway pathology, including ulceration, hemorrhage and abscess at the stoma or cuff site, subglottic erosion, and mucosal separation. There were no significant differences in any of the parameters studied between the group with and the group without airway pathology. The morbidity and mortality of cricothyroidotomy in adults are similar to that reported for tracheostomy. However, cricothyroidotomy should be avoided in children and adolescents because of the risk of subglottic stenosis.

Adolescent↗