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Biomedical subjects

M D Maves

Publications and source records attributed to M D Maves.

52 records · Page 3Linked to original sources
PubMed1984

Computed tomography and thin-section tomography in facial trauma.

The efficacy of radiographic methods in detecting and classifying facial fractures was assessed. Thirty-one patients with maxillofacial trauma were studied with plain radiography, coronal and lateral pluridirectional tomography (PT), and axial and direct coronal computed tomography (CT). PT and CT were compared to assess how many fractures each method could demonstrate. In addition, plain films were used in combination with each special study to see how efficacious each combination was at classifying fractures into types, such as blow-out, tripod, etc. To reflect the fact that it is sometimes impossible to obtain lateral PT or direct coronal CT scans at this institution, the same analysis was done using just coronal PT and axial CT. With two projections, CT was better than PT at demonstrating fractured surfaces (168 vs. 156) and in classifying fractures in combination with plain films (48 vs. 43). However, when only one projection from each special study was used, PT surpassed CT in showing fractures (137 vs. 124) and in classifying fractures (42 vs. 40). Failures with each method occurred when the plane of section was parallel or oblique to the plane of the structure being examined, that is, axial CT failed to show the floor of the orbit well and coronal PT failed to show the anterior maxillary sinus wall well. Imaging in two planes, including the coronal plane, is desirable for greatest accuracy in fracture detection, whether by CT, PT, or both. CT is generally better for the display of soft-tissue abnormalities.

Evaluation Studies as Topic↗
PubMed1982

Titanium tray mandibular reconstruction.

Mandibular reconstructions still present a difficult and challenging problem. Failures experienced in using rib or iliac bone grafts stimulated clinical and research activities in evaluating the following new techniques: composite myocutaneous bone flaps, bone transplants with microvascular anastomoses, and freeze-dried homografts. This article describes the usefulness of the titanium tray with or without cancellous iliac bone grafts for mandibular reconstruction. The series presented herein includes 12 patients who underwent mandibular reconstruction after trauma or ablative cancer surgery, No immediate or delayed extrusion of the titanium tray was observed with follow-up as long as eight years after surgery. Advantages and disadvantages of this technique will be discussed.

Bone Transplantation↗
PubMedDate not supplied

Relationship between psychological status and compliance in a sample of patients treated for cancer of the head and neck.

BACKGROUND: the psychological status of patients treated for advanced head and neck cancer is an area of patient care that has not received sufficient attention from caregivers and can be influential in terms of patient outcomes. METHODS: Thirty patients participated in this study designed to evaluate areas of psychological distress associated with treatment of advanced head and neck cancer. Patients completed a set of questionnaires related to various psychosocial variables including anxiety, depression, social support, health locus of control, adjustment to illness, illness-related behaviors, and compliance. RESULTS: Moderate levels of depression and anxiety, disability, and psychological distress characterize this sample of patients. Additionally, patient self-report of compliance reveals different variable combinations to be related to overall diet and medication compliance, and different levels of each compliance type were observed. CONCLUSION: Head and neck cancer therapy presents a unique set of challenges for patients. Awareness of the impact of the illness and the psychological distress that are experienced should improve patient compliance and medical outcome.

Adaptation, Psychological↗
PubMedDate not supplied

Botryomycosis of the oral cavity.

Botryomycosis is a bacterial infection characterized histologically by granules containing bacteria. Usually there is surrounding granulomatous inflammation with occasional extension into muscle or bone. While there are several hypotheses regarding the pathogenesis of botryomycosis, the exact mechanism is unclear. Botryomycosis has been associated with a variety of aerobic and anaerobic bacteria, usually endogenous flora and low virulence organisms. Oral lesions appear to be uncommon despite continuous exposure to endogenous oral flora. Treatment should include surgical excision and antibiotic therapy.

Humans↗
PubMedDate not supplied

Cavernous sinus involvement in head and neck cancer.

Spread of tumor to intracranial structures is an infrequent and late manifestation of head and neck cancers. We recently encountered six patients with a distinct clinical syndrome due to involvement of the cavernous sinus, which forms the basis of this report. This syndrome was a source of significant morbidity and mortality, with a mean survival of only 4 months. The diagnosis is often elusive, but is now made more commonly than previously. Whether this reflects increased incidence (due to alterations in the natural history of disease by therapy) or improved diagnosis (due to modern imaging modalities) is unknown. Cavernous sinus involvement may be the first evidence of distant disease in head and neck cancer. Although survival is poor, palliation is worthwhile. Awareness of this syndrome can lead to earlier diagnosis and alteration of treatment.

Aged↗
PubMedDate not supplied

Intraoperative transcranial Doppler ultrasound in head and neck surgery: a preliminary report.

PURPOSE: To evaluate the possible role of intraoperative cerebral emboli in the origin of perioperative stroke during major head and neck surgical procedures. MATERIALS AND METHODS: Eleven patients undergoing major head and neck surgery that involved direct manipulation of the carotid sheath were the participants in this study. Transcranial Doppler (TCD) ultrasound was used intraoperatively to detect possible cerebral emboli. The presence or absence of intraoperative cerebral emboli in each patient was assessed by the presence or absence of typical embolic signal patterns within the TCD waveform. RESULTS: No intraoperative cerebral emboli were noted in the series, nor did any patient have a postoperative stroke. CONCLUSIONS: No intraoperative cerebral emboli were noted by using TCD ultrasound for embolus monitoring in patients undergoing major head and neck surgery involving carotid sheath manipulation. This detection system is easily used in appropriate head and neck cases and allows real-time, noninvasive intraoperative monitoring.

Adult↗
PubMedDate not supplied

Infratemporal fossa meningioma: CT and MR findings.

We report an unusual case of an extracranial meningioma presenting as a large facial mass. The CT and magnetic resonance findings and a brief review of extracranial meningiomas are presented.

Facial Neoplasms↗
PubMedDate not supplied

Primary vocal rehabilitation using the Blom-Singer and Panje voice prostheses.

Vocal rehabilitation by means of tracheoesophageal puncture and placement of either the Blom-Singer or Panje silicone prosthesis has become a standard method of speech production following total laryngectomy. The same technique has been employed primarily at the time of the laryngectomy by the Department of Otolaryngology-Head and Neck Surgery, Indiana University Medical Center, and our experience with 11 patients undergoing this technique forms the basis for this report. Of the ten patients available for evaluation, all have developed satisfactory prosthetic speech 2-12 weeks following total laryngectomy. Advantages of this technique include the utilization of standard laryngectomy without compromise of oncologic principles, elimination of a second procedure to place the tracheoesophageal puncture, elimination of the nasogastric tube, care in the pharyngeal closure to afford the maximum success of prosthetic speech production, and finally, the psychological boost. Limitations of the technique have been few but relate to limited voicing with postoperative radiotherapy and unrealistic patient expectations.

Aged↗
PubMedDate not supplied

Esophageal burns secondary to disc battery ingestion.

Accidental ingestion and impaction of disc batteries in the esophagus has been a constant predictor of severe morbidity presumably due to leakage of highly caustic potassium or sodium hydroxide contained in these electric cells. Fewer than ten reports of esophageal burns from disc battery ingestion have appeared in the medical literature; an additional case involving ingestion of a mercury disc battery was recently encountered at the James Whitcomb Riley Hospital for Children, Indiana University School of Medicine. Two children died as a direct result of the impaction and resultant esophageal burn; six children experienced perforation of the esophagus, with four children developing tracheoesophageal fistulae. We report the ingestion of a 1.35-V mercury camera disc battery by a 10-month-old girl in whom a severe burn of the anterior midesophagus was noted 18 to 22 hours after impaction. The child subsequently developed a tracheoesophageal fistula and esophageal stricture at the site of the burn and required tracheotomy, closure of the fistula, partial esophagectomy and gastrostomy for eventual successful management. Stimulated by this experience, we have conducted an in vivo study of the time course and severity of esophageal burns resulting from alkaline and mercury battery ingestion in 15 cats. Mucosal damage can be seen as early as one hour after ingestion, rapidly progressing to involvement of all muscular layers by four hours. Removal of this foreign body should be assigned highest priority to prevent rapid development of these burns and the long-term sequelae mentioned above.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Effects of neutralizing agents on esophageal burns caused by disc batteries.

The sequelae associated with ingested disc batteries that lodge in the esophagus may include tracheoesophageal fistula, esophageal perforation, stricture formation, or death. The focus of the current investigation is on whether medical therapy can arrest or lessen the severity of the injury during the time required to transport the patient to a center for treatment. A case of esophageal damage from the ingestion of a 1.5-V manganese dioxide disc battery in a 3-year-old boy is reported also. A two-phase study was completed in which the initial phase was an in vitro experiment to identify potable solutions that might neutralize the alkali contained in disc batteries. An in vivo study in 24 cats was undertaken to determine if bolus administration of these solutions would arrest or lessen the severity of the esophageal injury. None of the solutions tested demonstrated a significant difference in the degree of gross or histologic esophageal damage when compared to controls.

Acetates↗
PubMedDate not supplied

Surface-active substances of the guinea pig tubotympanum: a chemical and physical analysis.

An attempt to describe the nature of the surface-active substances of the eustachian tube lining layer that influence normal tubal function was undertaken. Under sterile conditions, guinea pig tubotympanic washings were collected, centrifuged, and pooled. Analysis of the pooled lavages using standard surface chemistry techniques confirmed the presence of significant surface-tension-lowering activity in the mucous lining layer of the eustachian tube, but the surface pressure obtained is neither as great nor displays the same degree of hysteresis as pulmonary surfactant. Following separation into aqueous and lipid fractions, measurable amounts of surface activity can be found in both isolates. The chemical composition and concentration of the lipid fraction, and its relative contribution to the surface activity of the tubotympanic washings, however, is smaller and radically different from the phospholipids found in surfactant. A significantly higher concentration of protein was recovered in comparison with the lipid portion, and it was observed that the surface activity of the total washings and the aqueous phase bore remarkable similarities. Although the surface-tension-lowering properties of the tubal lining layer may be the consequence of a combined synergistic action of the lipid and protein moieties, we believe that the current evidence points toward the proteins as being the primary tubal surface-tension-lowering substances.

Animals↗