Biomedical subjects
Publications and source records attributed to R E Berktold.
Extracranial meningiomas comprise approximately 2% of all meningiomas. Primary extracranial meningiomas are even less common. This report details our experience with these unusual tumors from 1972 to 1989. The diagnosis, surgical management, and significant histopathologic features are discussed. The correlation of primary extracranial meningiomas with neurofibromatosis type II and a treatment algorithm are presented.
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Minoxidil is a potent peripheral vasodilator used to treat patients with severe hypertension that is unresponsive to other medications. Hypertrichosis of the forehead, face, neck, shoulders, upper part of the arms, and legs is a frequent side effect that occurs in the majority of patients that use this drug. This phenomenon appears to be due to increased blood flow to hair follicles, with resultant excessive hair growth. We describe a patient with severe hypertrichosis of the external ear canal resulting in chronic otitis externa and hearing loss.
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Chin reconstruction after radical surgery for carcinoma of the oral cavity is a complex and controversial problem. We have developed a simple, single-stage, primary procedure for chin reconstruction. It is easily mastered and is based on a simple modification of the pectoralis major myocutaneous flap. Our experience includes seven cases, including two with total chin reconstructions. The number and type of complication is low and consistent with the magnitude of the surgical procedure. This operation provides acceptable aesthetic and functional results to patients undergoing partial or total resection of the chin.
The treatment philosophy of carcinoma of the oral cavity is explained. Specific guidelines for therapy of various head and neck sites are offered as a rational approach to formulation of individual treatment programs.
Current theories of carcinogenesis suggest that premalignant changes should be expected in any area of the mucous membrane exposed to a carcinogen. The place of triple endoscopy in the workup and management of head and neck malignant neoplasms has been well established. Hematoporphyrin derivative has been shown to lend reproducible results in the study of tumor fluorescence. This compound has been used in in vitro and in vivo diagnosis and in the treatment of various tumors. It has not been used extensively in the head and neck, but its properties are ideal for diagnosis and treatment of selected head and neck tumors. Potential applications of photoradiation therapy in otolaryngology-head and neck surgery include detection of small primary tumors, delineation of resection margins, detection of early recurrences, and palliative and curative therapy of lesions.
This article reviews our experience with 86 patients undergoing 95 pectoralis major myocutaneous flap reconstructions. Complications and their incidence were very similar to those reported in previous series. Three cases of hidden recurrences appear to be previously unreported complications. The problem of delayed detection of recurrence in at-risk patients is an important one and may be unique to myocutaneous flaps. With the exception of the problem of hidden recurrence, the pectoralis major myocutaneous flap compares favorably with other methods of reconstruction of head and neck defects. Its size, viability, and versatility make it a valuable tool for extending the limits of resectability and reconstruction.
Neck abscess and mediastinitis are rare complications of cervical spinal injury. Often there is a delay in diagnosis because the physical and laboratory signs of abscess are falsely attributed to the vertebral injury. Prognosis is directly related to the expediency of recognition of infection and surgical drainage. Three cases of neck abscess with mediastinitis that were seen over a four-year period at the spinal cord unit at Northwestern Memorial Hospital are reviewed.