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Biomedical subjects

T D Wang

Publications and source records attributed to T D Wang.

At least 55 records · Page 3Linked to original sources
PubMed1991

Steroids and rhinoplasty. A double-blind study.

Many facial plastic surgeons use perioperative steroids to reduce postoperative edema and morbidity. This use of steroids is based more on theory and anecdotal experience than on controlled studies. We studied 49 patients undergoing rhinoplasty in a randomized, double-blind fashion to evaluate the effects of perioperative and postoperative steroid use. We found significantly less postoperative eyelid and paranasal edema in those patients receiving steroids. In addition, trends toward less ecchymosis, less intranasal edema, and less discomfort in the patients receiving steroids were noted.

Adolescent↗
PubMed1991

Experimental study on microvascular anastomosis using a dissolvable stent support in the lumen.

A new method for microvascular anastomosis was developed and compared with conventional techniques, using the rabbit femoral artery. A dissolvable stent biomaterial was placed in the lumen to expose the vessel walls clearly, so that the quality of anastomosis could be improved. The results showed no significant difference in immediate and late patency rates between the methods, but the use of the stent resulted in faster repair, less dilation at the anastomosis, and less narrowing of the distal segments, causing apparently minor hemodynamic disturbance, with increased blood flow distally. Minor damage to the vessel walls and rapid healing of the wound were verified by histologic evaluation.

Anastomosis, Surgical↗
PubMed1991

Spectrum of results after treatment of rhinophyma with the carbon dioxide laser.

Between 1986 and 1989, 30 patients with rhinophyma were treated with the carbon dioxide (CO2) laser at our institution. The duration of disease ranged from 1 to 20 years, and the duration of follow-up ranged from 1 to 4 years. All the patients were men, and all had fair skin (predominantly type I skin); their mean age was 63 years. Patients with minor and moderate rhinophyma were treated with CO2 laser vaporization only, whereas patients with major rhinophyma were treated sequentially with CO2 laser excision and then vaporization. A spectrum of long-term results is presented. Although dilated pores developed in many patients, no re-treatment with the CO2 laser was necessary. In one patient each, leukoderma, unilateral alar lift, and mild hypertrophic scarring developed. In general, use of the CO2 laser is effective for precise decortication of rhinophyma in an office-outpatient setting.

Adult↗
PubMed1990

Significant premaxillary augmentation.

Substantial premaxillary augmentation is necessary as an adjunctive treatment in most cleft rhinoplasties and in those patients exhibiting an acute nasolabial angle due to retrusion of the premaxila. We describe our technique of evaluation and treatment of this condition using a custom-carved piece of material made from a woven combination of Teflon and organic fibers (Proplast). Detailed technical illustrations as well as patient results are demonstrated. We have found this technique in our hands to be a simple, safe, and effective means of correction of significant premaxillary retrusion.

Adult↗
PubMed1990

Histopathologic evaluation of adipose autografts in a rabbit ear model.

Injection of autologous adipose tissue removed via liposuction has been used clinically for facial contouring, the aging face, furrows, facial atrophy, acne scars, nasolabial folds, chin, and various other surgical defects. Survival rates for autografts of fat have been quoted anywhere from 30% to 80%. Our study uses a reproducible rabbit animal model for autotransplantation of adipose tissue and examines the histopathologic changes that occur to the graft over time. Autogenous subcutaneous fat was removed from a dorsal scapular donor site, treated to stimulate cannula damage as in liposuction, then reinjected at the base of the ear. Histologic examination of the grafts were made at 5, 10, 15, 20, 40, and 100 days after transplantation. Hematoxylin-eosin sections were graded on degree of fibrosis present (0 to 4+), viable fat (1 to 10), degree of inflammation (0 to 4+), and neovascularization (+ or -). Viability of fat decreased from 8.5 to 10 at 5 days to 2 viability at 40 days. Acute inflammation peaked at 10 days, followed by the chronic inflammatory response with macrophages and multinucleated giant cells scavenging the dying fat graft. Neovascularization began at 5 days, peaked at 10 days, and remained constant thereafter only at the edge of the graft. Microcysts appeared at 15 days and increased in number in proportion to the decrease in viable fat. In summary, the temporal histologic events are progressive fibrosis; decreased amount of viable fat; inflammation beginning with a neutrophilic response, later a macrophage and giant cell response; and neovascularization at the periphery of the graft insufficient to maintain graft viability.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1990

Vertical frontal subtotal laryngectomy and immediate reconstruction of larynx with cervical skin flap.

Vertical frontal subtotal laryngectomy, a procedure that can remove as much as 90% of the larynx, was used to produce a functionally acceptable neolarynx with adjacent cervical skin flaps. Thirty-four patients with laryngeal carcinoma underwent this operation. All patients were staged according to their physical findings before operation. Of these patients, 1 was lost to follow-up and 2 died from other causes 6 months and 4 years after operation respectively. The remainder are living and well without recurrence. The longest follow-up was 8 years and the shortest 14 months. Laryngeal functions were restored completely in 27 patients and partially in 7. We conclude that the procedure is best suited for the removal of anterior commissure tumor extending from both vocal cords to the anterior 1/3 or the entire length of the true cords and that if the tumor extends to the supraglottis or subglottis, this procedure is adequate as long as the posterior part of the larynx is not involved, leaving a sufficient safety margin.

Humans↗
PubMed1989

The versatile midforehead browlift.

Ptosis of the brow is a significant and often unrecognized portion of aging of the upper face. It contributes to both cosmetic and functional aging. Correction is often mandatory prior to blepharoplasty in that functional problems may be worsened without elevating the brow. Direct and coronal browlifts are the most common approach to the problem. Midforehead browlifts have been reserved for men with receding hairlines. We have, for the past three years, performed midforehead browlifts on all our patients needing ptotic brow correction. Our review of 72 patients treated in this way, including 52 women, shows excellent and long-lasting cosmetic and functional improvement. There have been few complications, and the resultant incisional scars have been very well accepted. Therefore, we feel that the midforehead browlift, performed as we describe, is the ideal surgical correction for the ptotic brow.

Adult↗
PubMed1989

Rhytidectomy for treatment of the aging face.

Rhytidectomy or face-lift is an operation designed to remove facial wrinkles. Most often, it is performed in conjunction with other facial procedures, such as brow-lifts, blepharoplasty, and submental liposuction, for complete rejuvenation of the aging face. The recent surge of interest in cosmetic surgery has prompted more patients to inquire about and undergo a face-lift operation. Careful preoperative selection of patients is extremely important in achieving a successful outcome. At the Mayo Clinic, most facial cosmetic surgical procedures performed by the Department of Otorhinolaryngology are done on an outpatient basis. A combination of local anesthesia and intravenous sedation provides excellent patient tolerance and comfort both intraoperatively and postoperatively. Treatment involving the superficial musculoaponeurotic system is used for those patients who require additional underlying support and definition of the facial contour. Postoperative recovery is routinely uneventful. Complications of face-lift surgery are rarely encountered. Case reports are presented to illustrate the representative postoperative results.

Aging↗
PubMed1989

Preservation of laryngeal function after removal of carcinoma of the pyriform sinus.

Since March 1978, conservative laryngopharyngeal surgery has been used in the treatment of carcinoma of the pyriform sinus at this hospital. For pharyngeal reconstruction, cervical skin flap, deltopectoral flap, free microvascular bowel transfer, and pectoralis major myocutaneous flap and gastric pull-up transfer were used. The remaining part of the larynx was repaired with cervical skin flap, sternohyoid myofascia, epiglottis or remnant of epiglottis for complete rehabilitation (phonation, deglutition protection and respiration) or partial rehabilitation (phonation and deglutition protection) of laryngeal functions. 47 patients with carcinoma of the pyriform sinus were treated, and fairly good results were obtained. The 5-year survival rate was 41.7%, and the 3-year survival rate 50%. The laryngeal function restored completely in 31 patients and partially in 16. It is suggested that preservation of the unaffected part of the larynx is feasible both for eradication of tumor and preservation of laryngeal function.

Adult↗
PubMed1985

Hypoparathyroidism following total laryngopharyngectomy and gastric pull-up.

We have used the gastric pull-up technique for closure of large pharyngoesophageal defects after radical oncological surgery since 1979. The management of severe hypocalcemia and hypovitaminosis D seemed more difficult in patients undergoing pull-up reconstruction than in patients undergoing the same extirpative surgery, but reconstructed with more traditional methods. To determine if hypocalcemia and hypovitaminosis D were more common in gastric pull-up patients, and if postoperative management of these conditions is more problematic in this group, we retrospectively compared three groups of head and neck surgery patients. Group 1 consisted of 17 patients undergoing total laryngectomy with thyroid complex preservation. Group 2 consisted of 7 patients undergoing mediastinal dissection with total laryngectomy-thyroidectomy previously or concurrently. Group 3 consisted of 30 patients undergoing total laryngopharyngoesophagectomy-thyroidectomy and gastric pull-up reconstruction. The incidences of hypocalcemia requiring therapy were 12%, 50%, and 73%, respectively, with an overall incidence of 51%. The average amounts of supplemental calcium and vitamin D in the three groups were compared. A significant between the three groups was noted. Finally, the dietary calcium and vitamin D requirements for one problematic patient were prospectively recorded and summarized graphically. We conclude that any patient should be carefully monitored for the signs and symptoms of hypocalcemia after major head and neck surgery. In the special instance of the gastric pull-up patient, calcium requirements and the range of serum calcium fluctuation are greatly increased compared to patients undergoing more traditional methods of reconstruction.

Esophagus↗
PubMedDate not supplied

Secondary rhinoplasty in nasal deformity associated with the unilateral cleft lip.

The secondary nasal deformity of the unilateral cleft lip involves a retrodisplaced dome of the ipsilateral nasal tip, hooding of the alar rim, a secondary alar-columellar web, and other deficiencies. The sliding-flap cheilorhinoplasty effectively corrects these deformities using a laterally based chondrocutaneous flap. We modified this technique by using an open rhinoplasty approach with the laterally based chondrocutaneous sliding flap. Columellar struts and shield grafts were some of the techniques combined with this approach to produce optimal results. In a total of 7 patients, we performed both the original sliding-flap cheilorhinoplasty and the modified open rhinoplasty, which are described and discussed herein. The laterally based sliding-flap cheilorhinoplasty is an effective technique for correcting both the secondary nasal deformity and the lip scar associated with the unilateral cleft lip.

Adolescent↗
PubMedDate not supplied

A 3-year multi-institutional experience with the liposhaver.

OBJECTIVE: To report a 3-year multi-institutional clinical experience with the liposhaver in facial plastic surgery. DESIGN: Nonrandomized, nonblinded, multi-institutional evaluation of the liposhaver in a clinical setting. INTERVENTIONS: Seventy-two patients who presented for facial plastic surgical procedures underwent surgery with the liposhaver. Seventy-six liposhaving procedures and 74 concomitant procedures were performed. Standardized preoperative and postoperative photographs were obtained. OUTCOME MEASURE: Subjective evaluation by the surgeons who performed the procedures. RESULTS: The liposhaver was used successfully in all cases. The fat was cleanly shaved and the contour results were even, without dimpling or significant asymmetry. Operative time was comparable to that of conventional liposuction. There were no cases of facial nerve injury and no evidence of increased bleeding intraoperatively. Two male patients had small postoperative hematomas in the immediate postoperative period that were successfully treated with conservative measures. An additional patient developed a small hematoma on postoperative day 5 that was effectively treated with needle aspiration and a pressure dressing. CONCLUSION: This 3-year multi-institutional report suggests that the liposhaver continues to offer a precise alternative to conventional liposuction.

Equipment Design↗