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Biomedical subjects

M D Poole

Publications and source records attributed to M D Poole.

At least 73 records · Page 4Linked to original sources
PubMed1989

Experiences in the surgical treatment of cranio-orbital neurofibromatosis.

Experience with surgical management of cranio-orbital neurofibromatosis in 11 patients is reported. The surgery has a relatively high complication rate compared with craniofacial procedures for other conditions. The presence of an eye which is to be preserved in the orbit introduces difficulties in producing improved appearance without compromising corneal cover. A two-stage approach is recommended when an eye is present. The cosmetic improvements have been disappointing to the surgical team but generally worthwhile to the patients and their families.

Child↗
PubMed1989

A composite flap for early treatment of hemifacial microsomia.

A composite flap based on the thoracodorsal pedicle is described for use in the early surgical treatment of children with hemifacial microsomia, having absence or gross hypoplasia of the upper vertical ramus of the mandible and associated soft tissue hypoplasia in the cheek. The flap offers some fascinating possibilities in restoration of function and growth which have yet to be explored.

Adolescent↗
PubMed1989

Cranio-orbital trauma: a team approach to management.

We present 48 patients having multidisciplinary management following severe trauma to the fronto-orbito-nasal area. Surgical methods, including a preliminary débridement and later comprehensive repair are described in detail and results and problems are discussed. We wish to emphasise the better functional and cosmetic results that are gained by undertaking a comprehensive repair in the early post-injury phase, avoiding late intracranial infection, secondary surgery and prolonged hospitalisation. The techniques require cooperation between a reconstructive surgeon and a neurosurgeon.

Debridement↗
PubMed1988

Complications in craniofacial surgery.

200 consecutive patients undergoing craniofacial operations have been reviewed and the complications and problems encountered are reported. The complications were all among patients undergoing surgery in which intracranial exposure was used and the incidence was notably higher in some particular patient groups. Complications occurred in 22% of patients overall and the mortality rate was 1%. Complications in the 'disaster or life-threatening' category were seen in 9.5% of patients. Infection rate was low at 1%.

Adult↗
PubMed1987

Cross-facial nerve transplants: why are spontaneous smiles not restored?

The technique of cross-facial nerve transplantation (CFNT), with or without the addition of vascularised muscle, has made it possible to achieve some voluntary movement of the paralysed side of the face in patients with unrecovered facial palsy. If normal faces are studied during conversation, it can be seen that there are two types of movement of the lips--those of emotional expression and those involved in the formation of vowel sounds and labial consonants. Smiles themselves can be classified roughly according to their length of muscle contraction--the longer "definitive" smile, and the shorter "flash" smile. It is the synergistic facial movement of the unpremeditated "flash" smile and the small movements in the formation of the vowel sounds and labial consonants which fail to occur in patients reanimated by revascularised, reinnervated muscle, despite the return of voluntary contraction and resting facial tone. This study was undertaken to try to determine why these synergistic facial movements of short duration are so difficult to achieve.

Adult↗
PubMed1987

A review of nasolabial flaps for intra-oral defects.

The nasolabial flap has been used in 23 patients for reconstruction of moderate size intra-oral defects. Versatility in design of the flap is allowed by the numerous blood vessels supplying the nasolabial skin. Flap vascularity was reliable, there being no cases of total loss and three cases (12%) of partial necrosis. Recurrence of tumour occurred in 8.7% of cases and in those operated in the first instance for recurrence, there was no further local disease. There were minor problems of intra-oral hair growth, donor site distortion and obstructive sialadenopathy. However, because of its simple elevation, proximity to the defect and versatility, we believe that the nasolabial skin flap is a useful procedure for closure of selected intra-oral defects.

Aged↗
PubMed1986

Complications of radial forearm flap donor sites.

The complications of radial forearm flap donor sites in 15 patients from two centres have been reviewed. The complications included skin graft failure, swelling of the hand, stiffness of joints, reduced strength and sensation, cold-induced symptoms and fractures of the radius. Methods to reduce the incidence of such complications are discussed.

Adult↗
PubMed1986

The effect on the ear of late closure of the cleft hard palate.

Thirty-three patients with cleft palate are reviewed. The late effects on the ear of delayed closure of the hard palate after early soft palate repair are compared with the results of simultaneous early closure of both hard and soft palate clefts. Delayed closure of the hard palate does not affect the incidence of otitis media, the number of insertions of ventilation tubes or the findings on otoscopy. The prevalence of sensorineural hearing loss is significantly raised by late closure of the hard palate. The reason for this is unknown.

Adolescent↗
PubMed1986

Dermatofibrosarcoma protuberans: the problems of surgical management.

This paper reports the findings of a study of five patients each of whom had a dermatofibrosarcoma protuberans. The difficulties encountered in making an accurate clinical diagnosis and ensuring adequate surgical excision of this uncommon skin tumour are discussed. Recommendations are made on methods designed to reduce the high recurrence rate normally associated with this locally aggressive tumour.

Adult↗
PubMed1986

Reconstructive surgery in the treatment of intraoral cancer.

Patients with intraoral cancer present to various specialties. A series of 63 patients shows the importance of modern reconstructive surgery for patients treated by tumor excision. The reasons why a variety of techniques must be available to the patient are discussed. The advantages and disadvantages of some of these methods of reconstruction are reviewed.

Carcinoma, Squamous Cell↗
PubMed1986

Maxillary advancement in cleft palate patients. A modification of the Le Fort I osteotomy and preliminary results.

A technique for maxillary advancement at the Le Fort I level in cleft palate patients is described. A partial thickness palatal flap which leaves the greater palatine vessels in situ allows the maxilla to be repositioned anteriorly without displacing the soft palate. This leaves velopharyngeal function undisturbed whilst maintaining a good blood supply to the maxilla. This operation has been carried out on 7 patients and preliminary observations on the results have been made using speech assessment, nasendoscopy, Doppler flow studies and an assessment of skeletal relapse. Six of the patients had either no change or an improvement in speech and showed no significant change on nasendoscopy. One patient's speech deteriorated. Doppler studies, which were only possible in 3 patients, demonstrated blood flow in the greater palatine vessels when tested approximately 4 months postoperatively. The average skeletal relapse was 29% of the operative advancement.

Adolescent↗
PubMed1985

Prostaglandins and other metabolites of arachidonic acid. An overview for the otolaryngologist.

Metabolites of arachidonic acid have important regulatory functions within several areas of concern to the otolaryngologist. Prostaglandins, composing one group, are involved in smooth-muscle contraction, regulation of renal glomerular blood flow, and in the modulation of immune and allergic responses, inflammation, fever, pain, and tumor growth. A second group, the leukotrienes, may be even more important than prostaglandins in allergy and inflammation. The elusive slow-reacting substance of anaphylaxis belongs in this group. Two other metabolites, thromboxane and prostacyclin, seem to be critical in hemostasis and the metastatic spread of tumors.

Adrenal Cortex Hormones↗
PubMed1985

The serratus anterior/rib composite flap in mandibular reconstruction.

A flap comprising the serratus anterior muscle and the underlying rib, based on the serratus branches of the thoracodorsal artery has been developed. In addition to the rib the potential exists to include a cartilaginous growth centre, a functional muscle and/or overlying skin. A latissimus dorsi musculocutaneous unit can be included on a common pedicle. This paper describes its use as both a free and a pedicled composite unit in mandibular reconstruction. The surgical anatomy of the flap is reviewed and cases are shown to illustrate its use in the treatment of congenital, malignant and post-traumatic conditions where reconstruction of the lower jaw is required.

Adolescent↗