Biomedical subjects
Publications and source records attributed to John G Westine.
Classic techniques of scar revision in general are ablative and remain the gold standard, although newer nonablative laser therapies, such as the frequency-doubled neodymium:yttrium-aluminum-garnet laser, can help. Ablative therapies and techniques are examined.
Rhinoplasty and septoplasty are commonly performed surgical procedures that have as many variables in execution as the number of surgeons that perform them. Initially, these procedures were performed using manual instrumentation. Recently, however, powered instruments have been used to perform portions of the two procedures. Powered oscillating rasps have been described for reducing dorsal bony humps during rhinoplasty, and it has been suggested that powered osteotomes may reduce tissue trauma when performing nasal osteotomies. Powered burrs have also been used for taking down dorsal bony humps and refining boney irregularities. Although septal spurs have traditionally been excised manually, powered instrumentation has proved useful in this area as well. This article reviews the indications for using powered instrumentation in rhinoplasty and septoplasty.
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OBJECTIVES: To define the composition of tympanostomy tube plugs because selecting or developing effective solvents depends on such knowledge. STUDY DESIGN: Prospective, in vitro laboratory study. METHODS: Luminal contents of 105 plugged, microscopically removed tympanostomy tubes were expressed, pooled, acid hydrolyzed, and passed through a high-performance liquid chromatography column. Retention times were compared with high-performance liquid chromatography standards to develop free amino acid and monosaccharide profiles. Cerumen, blood, and chronic mucoid effusion (collected during myringotomy) were pooled and subjected to the same analysis. The elution profiles of each substance were compared to determine which substance most closely matched the plugs. RESULTS: High-performance liquid chromatography amino acid and monosaccharide analysis demonstrated greatest similarity between tympanostomy tube plugs and mucoid effusion. CONCLUSIONS: Tympanostomy tube plug composition is more similar to mucoid effusion than to blood or cerumen. Solvents to open plugged tympanostomy tubes should be directed against the components of mucoid effusion.
OBJECTIVE: To determine the most effective solvents for dissolving plugged tympanostomy tubes. STUDY DESIGN: In vitro laboratory study. METHODS: Twelve solvents (including ototopical antibiotics and water) were applied to fluoroplastic tympanostomy tubes (n = 260) plugged with dried mucoid middle ear effusion in an ear canal-tympanic membrane model. Time to clearance of the tympanostomy tubes was both visually and tympanometrically determined. RESULTS: Vinegar (P =.0030) and hyaluronidase solutions (P =.0030) were significantly better solvents than water. CONCLUSION: Vinegar and hyaluronidase solutions are more likely to clear plugged tympanostomy tubes than water and ototopical antibiotics, but vinegar is the preferred solution because of its known relative safety for use in the ear.
OBJECTIVE: To determine the impact of interventions on the degree of warping of costal cartilage. METHODS: The project was conducted at a large university animal research laboratory. The costal cartilage of eight 30-kg domestic pigs was harvested. The cartilage was cut into central and peripheral segments with a standard cutting die. Two sizes of rectangular cubes were compared. The central portions of costal cartilage were segmented and glued with octyl-2-cyanoacrylate. The shape of the cartilage was documented with both digital and film photography. The cartilage was placed into subdermal pockets on the dorsum of the pigs. The animals were killed at 4 weeks, and the cartilage was photographed. Adobe Photoshop software was used to measure the degree of warping. Statistical analysis was calculated by t test analysis. RESULTS: A total of 115 rectangular costal cartilage blocks were treated. Large blocks warped less than small blocks (P<.02). Centrally cut blocks warped less than peripherally cut blocks (P<.03). The octyl-2-cyanoacrylate incited a significant sterile inflammatory response such that the blocks could not be accurately assessed for warpage. CONCLUSION: Costal cartilage can be effectively used for grafting in rhinoplasty with minimal warping if large grafts from the central portion of cartilage are used.