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Biomedical subjects

J Conley

Publications and source records attributed to J Conley.

51 records · Page 3Linked to original sources
PubMed1977

Melanoma of the head and neck.

A retrospective review from 1935 to 1962 of 772 melanomas involving the head and neck seen at the Pack Medical Foundation (PMF) is presented with the main emphasis of 660 cutaneous and mucosal melanomas. Clark's levels for pathologic invasion are presented and correlated to 289 cases with 19 percent in Level II and 81 percent deeply invasive at Level III, IV, and V. The face was the most commom location with the cheek alone accounting for 22.3 percent of all the cases. The male to female ratio was 1.5 to 1 with 76 percent of the cases being equally distributed among the fourth through the seventh decades. 55.9 percent were local disease, Stage I, with 33.5 percent, Stage II, and 10.6 percent, Stage III or distal disease. The five-year or greater absolute cure rate in positive nodal disease was 12.6 percent. Elective versus no elective neck dissection in Stage IA disease demonstrated a five-year or greater absolute cure rate of 55 percent as compared to 38.5 percent. Distal metastases occurred in 30 percent of cases with elective neck dissection but in 70 percent of those cases with therapeutic neck dissection. The absolute five-year or greater cure rate was able to be analyzed in 556 cases. The rate was 25.6 percent for the mucosal and cutaneous lesions combined; an 8 percent rate for mucosal alone and 27.8 percent for cutaneous melanoma. The five-year or greater absolute cure rate for those cases treated totally at PMF was 35.4 percent.

Female↗
PubMed1976

Malignancies of the ear.

Cancer of the ear is an uncommon occurrence and rarely diagnosed early it its development. Routine biopsy of all granulomatous and neoplastic diseases of the ear is essential to early diagnosis. Polytomography is an aid in documenting the extent of the disease in bone. The surgical anatomy of the region of the ear imposes special disadvantages upon any type of surgical technique employed and supervoltage irradiation given. Temporal bone resection and its modifications, combined with irradiation, enhance the cure rate in the advanced cases and add significantly to the local control of this disease. A review of 273 cases is presented.

Adenocarcinoma↗
PubMed1975

Prognosis of malignant tumors of the parotid gland with facial paralysis.

A parotid malignant tumor with spontaneous facial nerve involvement is a serious prognostic sign. Of 34 patients reported, 29 have been followed for at least five years. In this group, 20 are dead of disease (one at five years), one is dead of other causes (at seven years), one is living with disease, and seven are free of disease. Four of these seven cases have been followed for more than ten years, with two being free of disease for 12 years. Thus, it is not a hopeless situation, as some studies have shown, and not a contraindication to combined radical surgery and radiotherapy treatment for cure if not palliation.

Adenocarcinoma↗
PubMed1975

Modified nondelayed forehead flap.

The versatility and benefit of the forehead flap need not be lost when the external carotid artery system has been ligated. By basing the forehead flap laterally on the scalp, nourishment from the opposite external carotid artery gives the head and neck surgeon another advantage in reconstruction with nondelayed expedience. We report three cases of wide cheek ablative surgery, external carotid ligation, and utilization of the forehead flap. The occasions to use this modified nondelayed forehead flap are few, but it offers the same advantage without staging. It definitely can be used in any situation requiring a forehead flap when the external carotid artery system has been ligated.

Aged↗
PubMed1975

Regional skin flaps in partial laryngectomy.

The use of regional neck flaps for rehabilitation has permitted an extension of operations on the glottis. The resection may include both vocal cords, both ventricular bands, one arytenoid and slight subglottic extension in a one- or two-stage technique. The resultant voice is low pitched, soft and has limited range. The cure rate was 85 percent.

Humans↗
PubMed1975

Radical neck dissection.

Radical neck dissection has evolved into a standard surgical technique over the past century. It has been the most effective method of attempting to control suspected or gross metastasis to the cervical region. The technique embraces the en masse removal of all tissue elements in the space between the subdermis and the fascia colli. The perimeters of the dissection extend from the midline anteriorly to the anterior border of the trapezius muscle posteriorly, and from the clavicle to the mandible. The essential portion of this large mass of tissue is the cervical lymph system with its lymph nodes and afferent and efferent connecting vessels. Controllability of the cancer process is in direct proportion to the number of nodes involved, their size and their position in the neck. Complications in the routine radical neck dissection are minimal. Cure rates are influenced by the type, size and site of the primary cancer, the possibilities for the adjunctive treatment such as radiotherapy and chemotherapy, and the, as yet, little understood immunological factors. The radical neck dissection has proven itself to be an essential tool in the management of cancer in the head and neck.

Accessory Nerve↗
PubMedDate not supplied

The surgical treatment of extratemporal facial paralysis: an overview.

At present there is no single surgical approach that is ideally suited to rehabilitation of the paralyzed face. Dynamic reconstruction and neural reconstitution are usually preferred to static methods, except under special circumstances. Experience with over 150 autogenous facial-nerve grafts using epineural suture technique has resulted in return of movement in 95% of properly selected patients. When grafting is not feasible, as in the obliterated central facial nerve, hypoglossal-facial-nerve crossover is a simple and powerful source of reinnervation, usually resulting in minimal intraoral crippling and mild mass movement. A newer procedure, the cross-face nerve graft, is an alternative to hypoglossal crossover, although it results in less axonal input and longer regenerative time. In cases of long-standing facial paralysis with muscle atrophy, temporalis and masseter transfers are dependable and may sometimes be combined with a nerve graft.

Cervical Plexus↗
PubMedDate not supplied

Olfactory neuroblastoma.

Olfactory neuroblastoma is an uncommon malignant tumor arising from olfactory epithelium. Generally considered to be a tumor of slow growth, it varies in aggressiveness and may cause death by distant metastasis or local invasion. The pathologic diagnosis is difficult, and this tumor is often erroneously diagnosed. Nine previously unreported cases are presented, and a review of the various treatment modalities and course of the disease is given. Maximum therapeutic succes is best achieved by radical excision followed by a full course of radiation. Because of the high incidence of local recurrence (46%) and slow growth, patients should be followed up closely for life.

Adolescent↗
PubMedDate not supplied

The meaning of life-threatening disease in the area of the head and neck.

The revelation that one has a life-threatening disease creates a sentient flood of emotions that infuse the patient with fear, confusion and depression. It contains the spectrum of pain, suffering, deterioration of life-style, crippling and possible annihilation. This burden falls first on the patient and his family, and then on his doctor. The drama is a dilemma of cure or palliation wrapped about the emotional core of that person with science, drugs, technology, mysticism and hope. The ongoing process is the most dynamic encounter of being alive, and before it is finished will have used and drained a large percentage of the vulnerable emotions that identify our humanness. An overview of these involvements as they relate to the area of the head and neck shows how complex the process has become, the remoteness of its solution and the truth of its experience.

Attitude to Death↗
PubMedDate not supplied

A new treatment for wrinkles.

A technique identified as threading is described for the treatment of wrinkles. Colorless 4-0 and 2-0 clear vicryl (Ethicon) has been threaded underneath the wrinkle for augmentation, and "basket weaving" has been applied to atrophic areas. As much as 40 feet of threads have been used at one time in the face. Complications are minimal, the results subtle, and the technique may be repeated. It is hoped that this concept will be developed further with the use of soft, colorless, nonabsorbable threading material (Prolene, Nurolon, Ethicon).

Dermatologic Surgical Procedures↗
PubMedDate not supplied

Composite pedicled rib flap for reconstruction of the mandible and face.

A new technique of bony and soft tissue augmentation to the mandible, face, and neck is presented. It consists of a composite soft tissue flap from the anterior chest, including two ribs attached and transposed without delay to the newly prepared tissue bed. The distal portion of this flap is de-epithelialized for soft tissue augmentation to the face. The ribs are wired to the mandible, and the flap is released in six to eight weeks. At that time, the proximal segment is de-epithelialized for further augmentation. The soft tissue mass is supported against gravity for three to four months with a chin strap. It is desirable to use this concept as a secondary procedure rather than associating it with the primary ablative technique. One can expect significant improvement in esthetics and contour from this technique.

Face↗