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Biomedical subjects

M J Earley

Publications and source records attributed to M J Earley.

At least 37 records · Page 2Linked to original sources
PubMed1990

A critical appraisal of the use of free flaps in primary reconstruction of combined scalp and calvarial cancer defects.

Eleven patients had scalp tumours with full thickness calvarial invasion excised and reconstructed with free flap transfer as a primary procedure. Latissimus dorsi or radial forearm flaps were used, with split rib calvarial reconstruction. One flap was lost peroperatively and another necrosed at 8 days following pedicle compression against an acrylic "skull". Only six patients presently survive, two being treated for recurrence. Long-term follow-up indicates that poor prognostic factors are advanced local invasion, squamous or anaplastic tumours, and advanced age. However, palliative treatment has a role.

Aged↗
PubMed1990

Focusable Doppler ultrasound in mapping dorsal hand flaps.

The dorsal arterial anatomy of 50 normal hands was mapped using high frequency pulsed wave Doppler ultrasound. The findings correlated with previous anatomical studies regarding the variability in the incidence of the arteries. Eight clinical cases were studied preoperatively, seven of whom underwent surgery involving local flaps. Intraoperatively the presence of the mapped vessels was confirmed in each case. This investigation defines the role of high frequency pulsed wave Doppler ultrasound in the mapping of dorsal hand flaps.

Adult↗
PubMed1990

Radiological assessment of hemifacial microsomia by three-dimensional computed tomography.

Hemifacial microsomia (HFM) is the commonest asymmetrical craniofacial deformity leading to underdevelopment of the craniofacial skeleton and soft tissues on the affected side. Timing of reconstructive surgery is based on a comprehensive analysis and classification of the deformity. Lateral cephalometric radiographs are of limited value because of superimposition of normal and abnormal bony structures. The skeletal and soft-tissue findings of six patients with HFM who underwent three-dimensional (3D) CT are presented. This method allows a comprehensive assessment of the deformity at a low radiation dose, 22% of that of a conventional CT scan, by the use of a low dose technique.

Adolescent↗
PubMed1989

Free flap surgery: the Welsh Regional Unit experience.

The evolution and uses of free tissue transfer since 1976 are documented. Two hundred free flaps have been performed with an overall success rate of 91%. The factors which may influence survival are the type of flap used, the recipient region and the timing of surgery following trauma. Twenty-five percent of cases required re-exploration postoperatively, of which 78% were successfully salvaged. Venous thrombosis was the commonest problem and appears better tolerated than arterial occlusion. Eighty-two percent of venous thromboses were salvaged compared with only 50% of arterial failures.

Adolescent↗
PubMed1989

Pharyngostome closure using the radial forearm free flap.

A technique is described using the radial forearm free flap for pharyngostome closure. The flap may be used in combination with local flaps for external cover only or may be raised as a double paddle for external and internal lining.

Aged↗
PubMed1989

A distally based first web flap in the foot.

A flap can be raised from the dorsum of the foot based distally on the first web-space. It is supplied by branches of the dorsal and plantar metatarsal arteries and their distal communicating branches. It is reliable, does not contract and is useful in resurfacing defects in the distal foot overlying the metatarsophalangeal joints.

Contracture↗
PubMed1989

Primary maxillary reconstruction after cancer excision.

Eleven patients who underwent primary maxillary reconstruction following cancer excision are presented. Low partial and high partial maxillectomies are recognised, as are the more radical excisions. Skin grafts, a temporalis muscle flap, free radial forearm flaps, single paddle, double paddle and triple paddle latissimus dorsi free flaps and a latissimus serratus, rib composite flap have been utilised. Oncological aspects and secondary reconstructive problems are detailed. Six patients have survived; three have died of recurrent disease and two of myocardial infarction some time after surgery.

Adult↗
PubMed1989

The first web hand flap.

Cadaveric dissections demonstrated a constant blood supply to the skin of the first web. An island advancement flap from the dorsum of the first web was used to release first web contractures in six patients and to resurface palmar burns in two. There were no flap losses and its use is recommended in release of moderate contractures and minor loss of palmar skin.

Adolescent↗
PubMed1989

The second dorsal metacarpal artery neurovascular island flap.

Eleven patients have had second dorsal metacarpal sensate island flaps used to cover local skin defects in the hand. The arterial supply is reliable but if the flap is extended beyond the proximal interphalangeal joint, distal flap necrosis or donor site difficulties may occur. Possible applications for this flap are demonstrated and some untried variations to increase its range are suggested. Its main use appears to be in the release of first web contractures and for resurfacing radio-palmar and thumb defects.

Adolescent↗
PubMed1989

Anomalous blood supply to the serratus anterior/rib composite flap.

The serratus anterior muscle and rib composite flap has been well described for oral and mandibular reconstruction. The flap may also be used in combination with the latissimus dorsi flap based on the common thoracodorsal vascular pedicle, a blood supply which has hitherto been proven to be reliable. This case demonstrates a totally independent arterial supply to the serratus anterior and latissimus dorsi muscles.

Blood Vessels↗
PubMed1987

Dorsal metacarpal flaps.

The history of dorsal metacarpal flaps and their anatomical basis is described. In thirty hand dissections, the fascial variety of the first dorsal metacarpal artery was present in 90% and the second dorsal metacarpal artery in 97%. The origin, course, branches and termination of these arteries are illustrated. Doppler ultrasonic flowmeter studies of the vessels in 52 hands are presented but shown to be unhelpful clinically. Two patients in whom the second dorsal metacarpal flap was used, are described and possible difficulties delineated.

Adolescent↗
PubMed1986

The arterial supply of the thumb, first web and index finger and its surgical application.

A detailed examination of twenty cadaver hands has been carried out in order to elucidate the arterial blood supply of the thumb, first web, and index finger, relating this to revascularization, replantation and possible flaps in that area. The vessels are described in turn, and it is demonstrated that the terms "princeps pollicis" and "arteria radialis indicis" are misnomers. The results of the dissections are compared to those of others and the differences recorded.

Arteries↗