Biomedical subjects
M F Ramadan
Publications and source records attributed to M F Ramadan.
A prospective randomized trial of suture material in aural wound closure.
The aim of the study was to compare synthetic monofilament suture materials with chromic catgut and silk in aural wound closure. Forty patients undergoing mastoidectomy or tympanoplasty were randomized to closure with either 3o PDS (Polydioxanone) to fascia plus 3o Prolene to skin, or 2o chromic catgut to fascia plus 3o silk to skin. Known or suspected factors affecting wound healing were recorded. Nine patients had post-operative wound infections. The infection rate was significantly lower in wounds closed with PDS and Prolene (chi 2 = 6.05, p less than .05), and in tympanoplasty operations (chi 2 = 4.42, p less than .05). Four patients suffered wound dehiscence, all four had been closed with catgut and silk. No other complication of wound healing was noted in the trial. In conclusion, PDS and Prolene are superior suture materials to catgut and silk in the closure of aural wounds.
A method for preparation of fibrin glue.
Otorhinolaryngological operations would be facilitated by the use of a safe, cheap, surgical adhesive. Though commercial fibrin glue is effective, it is both relatively expensive and, because it is prepared from pooled human blood, there has been concern that it carries the risk of transmitting viral disease, in particular hepatitis and acquired immune deficiency syndrome. We describe a rapid, cheap method of preparing sufficient fibrin glue, of adequate bonding power, from a small quantity of the patient's own blood, and therefore with no risk of contracting viral disease. Our method of preparation of fibrin glue promises to provide a valuable adjunct to otorhinolaryngological surgical practice.
Effect of experimental nasal obstruction on growth of alveolar arch.
Sixty 4-week-old New Zealand albino rabbits, obtained as 20 sets of littermates, were divided into three groups such that one rabbit from each litter appeared in each group. After radiological measurements of cranial dimensions, all animals underwent nasal electrocauterization. Group 1 underwent cauterization but no nasal obstruction was created. Cauterization was done to produce unilateral obstruction in group 2 and bilateral obstruction in group 3. After growth had ceased, the prepared skull of the mature animal was measured to assess the alveolar and cranial dimensions. The alveolar arch in the animals with bilateral obstruction was significantly narrower and shorter than in the control rabbits and in those with unilateral obstruction, but there was no significant difference in the palatal height among the three groups.
Mortality after surgery for hypopharyngeal cancer.
Results of 362 patients with squamous carcinoma of the hypopharynx are presented. The hospital mortality was 25 per cent for patients treated surgically. The mortality was increased by previous radiotherapy and poor general condition, and also depended on the method of pharyngeal repair: the mortality for visceral (stomach or colon) transposition was higher than that for repair by skin flaps. The chance of long term survival decreased with increasing N stage, and was also reduced for patients undergoing visceral repair compared with skin flap repair of the pharynx.
Experimental nasal obstruction and changes in the arterial blood gases.
This is a controlled animal experiment in which the effect of chronic nasal obstruction on the arterial blood gases was studied. Sixty female New Zealand Albino rabbits, in groups of 3 litter mates were assigned to 3 groups: control, unilateral nasal obstruction, and bilateral nasal obstruction. Nasal obstruction was produced using coagulating electro-cautery and the values of pO2, pCO2 and pH in the arterial blood were studied. In animals with unilateral nasal obstruction the blood gas values were similar to those in the control group. In animals with bilateral nasal obstruction there was a marked fall in pO2 and a marked increase in pCO2. These changes were statistically significant, but there was no significant change in arterial pH in any of the obstructed groups.
Epidemiology of laryngeal cancer.
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Management of post-cricoid carcinoma.
This paper discusses the results of treatment of post-cricoid carcinoma based on a personal series of 141 patients. The following conclusions can be drawn: small tumours with no clinical evidence of cervical lymph node metastasis should almost certainly be treated with radiotherapy, which gives a 5-year survival of approximately 35%. Surgery for recurrent disease after radiotherapy if fraught with complications, and satisfactory salvage is seldom possible. Surgery for larger tumours and those associated with neck node metastases has a lower (20%) 5-year survival with a high incidence of complications. The main problem after pharyngolaryngectomy is replacement of the pharynx. There is no evidence that any one of the methods in common use (skin flaps, transposition of the colon or stomach) is superior to any other.
The management of glottic T3 carcinoma.
In the treatment of glottic T3 carcinoma there are four possible methods (1) primary radical surgery, (2) primary radical radiotherapy, (3) radical surgery with preoperative irradiation or (4) partial surgery. This study shows that patients treated primarily by surgery achieve worse results than those treated by radiotherapy.
Post-cricoid carcinoma: the place of visceral transposition.
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An acquired oesophageal pouch in childhood: a problem of diagnosis.
A case report of a child with an acquired oesophageal pouch is presented. A chronically impacted radio-lucent coin in the oesophagus resulted in a dilatation of the oesophagus above the obstruction. This dilatation mimicked a pharyngeal pouch and the problems of diagnosis are discussed.
Reconstruction after pharyngolaryngo-oesophagectomy using delto-pectoral flap.
Fifty patients with hypopharyngeal cancer treated with total pharyngolaryngectomy and staged reconstruction using delto-pectoral flaps in the years from 1967-1976 were studied. The main complications were fistulae and stricture formation; these are described. The hospital mortality was low, and postoperative deaths only occurred in previously irradiated patients. The crude 5-year survival was 35%.