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Biomedical subjects

N W Yii

Publications and source records attributed to N W Yii.

12 recordsLinked to original sources
PubMed1999

Management of the N0 neck in early cancer of the oral tongue.

Elective treatment of the clinically negative neck in the management of early oral tongue cancers remains controversial. A retrospective review of 71 patients with T1, 2 N0M0 squamous cell carcinoma of the oral tongue treated at the Royal Marsden Hospital was carried out. Cervical nodal recurrence at 2 years was 17% in the group of patients who received elective neck treatment as compared to 43% in the group who had observation of the neck and the difference is statistically significant (P = 0.025). The difference in 5-year survival between the group who had elective neck treatment and the group who did not (75% versus 65%) was not statistically significant. Until future research allows us to be more selective on the basis of a reliable panel of histological and/or biological markers for propensity to nodal metastases, elective neck treatment should be considered in the initial management of the patients with early oral tongue cancer.

Carcinoma, Squamous Cell↗
PubMed1999

Bipedicle strap flaps in reconstruction of longitudinal dorsal skin defects of the digits.

Dorsal skin defects in which the loss of integument is longitudinal in shape are not uncommon after injury by rotating machinery and by glass shearing along the length of the digit. This shape of defect is difficult to reconstruct with commonly used flaps but lends itself to reconstruction by the use of longitudinal bipedicle strap flaps moved across the dorsum of the finger from lateral to medial. A variant of this traditional technique was used in the reconstruction of 28 dorsal digital defects. The incidence of these defects and the need for this reconstructive technique were analyzed by a review of 1077 patients with dorsal digital injuries treated in a 6-year period between 1989 and 1995. Approximately 20 percent of all dorsal digital injuries requiring flap reconstruction were suitable for reconstruction with bipedicle strap flaps.

Adolescent↗
PubMed1999

Use of apron flap incision for neck dissection.

Neck dissection is one of the most commonly performed surgical procedures in the management of head and neck cancer. Different skin incisions with various modifications have been described in the literature. Three commonly used but conceptually different incisions were compared with respect to the incidence of wound dehiscence in a retrospective review. There were 166 patients with 184 neck dissections carried out using a triradiate (n = 85), modified MacFee (n = 25), or an apron flap incision (n = 74). The incidence of wound dehiscence in the three groups was 11 percent, 8 percent, and 0 percent for the triradiate, modified MacFee, and apron flap incisions, respectively. There was a statistically significant difference in the incidence of wound dehiscence between the apron flap incision and the triradiate incision groups (p = 0.004). The difference in wound dehiscence was not statistically significant between the apron flap incision and the modified MacFee incision groups (p = 0.06). Overall, there was a significant increase in the incidence of wound dehiscence in previously irradiated necks (p = 0.02), but this was significant only for the triradiate incision (p = 0.005) when analyzed individually. Comparison of triradiate, apron, and MacFee incisions did not show a statistically significant difference between the incisions with regard to other postoperative complications in terms of seroma, hematoma, wound infection, and fistula formation. The apron flap incision is the recommended approach in the presence of previous neck irradiation as it gives easier access than the MacFee incision. The robustness of the flap is because of the absence of a trifurcate point as well as a good vascular supply arising from arterial territory of the external carotid artery.

Female↗
PubMed1998

A prospective study of flexor tendon repair in zone 5.

A prospective study of postoperative mobilization of flexor tendon repairs in zone 5 was conducted over a 2-year period between 1994 and 1996 using a controlled active motion (active extension-active flexion) regimen of mobilization. Fifty-two patients, who had a total of 151 flexor digitorum superficialis (FDS) and 103 flexor digitorum profundus (FDP) divisions, were available for review at a mean follow-up of 10 months. Of the 161 fingers with division of one or both flexor tendons, 66% exhibited independent FDS function and 90% achieved good or excellent results of digital range of motion. No rupture of an FDP tendon repair occurred during the study period. The data allowed us to define a new method of classifying the results of treatment of these injuries in terms of the injured wrists as a whole and not simply as a series of isolated observations for each individual finger with divided flexor tendons. The results of recovery of independent FDS action and range of finger movement achieved for injuries in which the flexors of all four fingers had been divided indicate a statistically significant interdependence of injuries of finger flexors of adjacent fingers at the wrist. Multivariate analysis showed the presence of a "spaghetti wrist" injury to have a significant adverse effect on the recovery of the independent FDS action but not on the recovery of the digital range of motion.

Adolescent↗
PubMed1996

Cervical necrotising fasciitis with pharyngeal perforation: treatment and reconstruction.

We present a case of life-threatening necrotising fasciitis of the neck with acute pharyngeal perforation following a parapharyngeal abscess caused by tonsillitis. The joint occurrence of cervical necrotising fasciitis and acute pharyngeal perforation has not been previously reported. A new way of reconstructing the pharyngeal defect using an islanded submental perforator flap is presented.

Acute Disease↗
PubMed1996

Lotus petal flaps in vulvo-vaginal reconstruction.

The perineum is an area of rich blood supply with multiple arterial anastomoses. Flaps raised on perforators around the perineum resemble the petals of the lotus and can be used to reconstruct a variety of vulvo-vaginal defects. Thirteen such flaps have been used successfully without any loss of flaps in eight patients. Eight flaps in four patients were used for vulvar reconstruction following radical vulvectomy.

Adult↗
PubMed1996

Unusual conchal deformity in otherwise normal ears.

A case of bilateral convex conchae in otherwise normal ears is reported. As far as we are aware, such a deformity has not been reported in the literature. A technique of surgical correction by excision of a crescent of conchal cartilage is described. Relevant embryologic development of the auricle is reviewed.

Cartilage↗
PubMed1991

Granulomatous pulmonary zygomycosis in a patient without underlying illness. Computed tomographic appearances and treatment by pneumonectomy.

Pulmonary zygomycosis rarely occurs in the absence of underlying disease. We report a patient with granulomatous pulmonary zygomycosis without underlying disease who presented with a pulmonary mass. We present the computed tomographic findings that we believe have not been described previously. We also report the successful treatment by pneumonectomy.

Aged↗
PubMed1991

Methicillin-resistant Staphylococcus aureus in surgical patients: Malaysian experience.

Methicillin-resistant Staphylococcus aureus has emerged as an important cause of nosocomial infections in recent years. During 1988 in the Department of Surgery of the University Hospital in Kuala Lumpur, Malaysia, 148 patients were shown to be infected or colonized with these organisms. The patients at risk were those who stay in hospital for greater than 14 days, those over 50 years of age, patients who underwent neurosurgery, cardiothoracic surgery, or were admitted with major burns. Of the 148 patients, 78 (52.7%) were clinically infected, the remaining 70 being colonized. A total of 28 patients died (18.9%) but only five (3.4%) as a direct result of this infection. The estimated annual cost of controlling the organism was found to be approximately MR$250,000. (50,000 pounds). This nosocomial infection therefore represents a serious problem, especially in developing countries where health funding and health facilities are limited.

Adolescent↗