Biomedical subjects
T M Davidson
Publications and source records attributed to T M Davidson.
Mandibular fracture complications.
This paper presents the authors' experiences with 111 treated mandibular fractures and 16 cases of complication. Pertinent data on the fresh fractures are given, but the major part of the study deals with cause, diagnosis, and treatment of the complications of mandibular fractures. These are divided into four categories-infection, nonunion, malunion, and temporomandibular joint ankylosis, although only infection and temporomandibular joint ankylosis are included here. Unique mandibular fracture complications are reviewed.
Conservative face lift surgery.
Face lift surgery almost always is elective; and, because its purpose is to diminish aging problems, it most often is done in those who are aged. Local and general risks, therefore, should be minimized. Wide undermining dictates flaps dissected more deeply and wounds closed well short of the limits of stretch of skin. Less radical undermining described here produces much smaller total wounds, lessens hazards of hematoma, considerably shortens operative and anesthetic times, reduces risks to nerves and ducts, and allows snugger closures. Details of operative technique, including platysma plication, are demonstrated. Short- and long-term results are shown. They indicate improvement sufficient to justify expanded use of the suggested techniques, particularly in view of diminished morbidity and risks to the general condition of those in the older age group.
M-plasty techniques.
Conventional closure of surgical defects in skin may cause unsightly protrusions (dog ears). Fusiform excisions with angles of 30 degrees or less reduce protrusion but may require excision of larger volumes and lengths of healthy skin and subcutaneous tissue than may be desirable. M-plasties reduce these requirements while still allowing use of 30 degrees angles at maximum. Applications and technical details are described and illustrated.
"Practical suggestions on facial plastic surgery--how I do it.".
For many years, we have used 6-0 catgut for closure of epithelial and superficial dermal wound edges. Only when absolutely necessary do we use deeper dermal or subcutaneous sutures. The superficial suturing is supplemented with antitension skin taping. Details of the technique are presented and reasons why satisfactory results occur are postulated. The recommended techniques have been used in closure of wounds on the face and body. It is emphasized that only certain catgut and antitension taping products work well.
Medial orbital wall fracture with rectus entrapment.
Two cases of medial orbital fracture with medial rectus muscle entrapment are reported, one a bona fide blowout fracture. Review of the literature reveals six previous cases. Clinically, patients complain of diplopia with lateral gaze and forced duction tests confirm medial rectus entrapment. Radiographic confirmation is best obtained with hypocycloidal tomography. Surgical therapy is indicated for diplopia or enophthalmus.
Endotracheal intubation with the flexible fiberoptic bronchoscope.
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Flexible fiberoptic laryngobronchoscopy.
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Tonsillectomy and Hodgkin disease.
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A purified procoagulant enzyme from the venom of the eastern diamondback rattlesnake (Crotalus adamanteus): in vivo and in vitro studies.
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Comparison of nerve regeneration rates following controlled freezing or crushing.
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Thrombic enzyme from Crotalus adamanteus.
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Radiographic evaluation for nasal dysfunction: computed tomography versus plain films.
Sixty-two patients, presenting to the Nasal Dysfunction Clinic at the University of California, San Diego, were radiographically examined with plain sinus x-rays and computed tomographic (CT) scans. The x-rays were evaluated independently, and the reported findings were compared. In maxillary sinuses the CT and plain film observations corresponded poorly with a concordance of 77%. There was a tendency to overread the plain films. In the ethmoid sinuses the lack of concordance between CT scans and plain films was 76%, and a tendency to underread the plain films was noted. In the lower nasal compartment the correspondence between CT and plain film readings was 57%, with a notable tendency to overread the plain films. In the olfactory recess, the CT/plain film concordance was 66%. At our institution, a sinus CT series costs $400; a conventional sinus series costs $102. The CT radiation dose is 5.2 to 6.5 cGY compared with 1.4 cGY for plain films. We conclude that plain films are unreliable and no longer routinely indicated for the evaluation of nasal and paranasal sinus disease. When radiographic evaluation is indicated a limited CT series provides superior information. Exceptions may include children and some cases of sinus disease isolated to a single sinus.
Metallic clips as a time/cost saving adjunct to head and neck surgery.
Metal surgical clips are commonly used in head and neck surgery today. In this study of 10 patients, 69 vessels in the neck were ligated with tantalum clips and 68 vessels were ligated with silk ties. The times for cutting and ligating each vessel were recorded and the results show a 31-second timesavings by clipping the vessel as opposed to tying. The use of metal clips on vessels is found to be both safe and effective, while reducing operative time.
Browplasty as an adjunct to rhinoplasty.
Brow modifications are discussed with respect to their role as aids in achieving certain aesthetic effects when rhinoplasty is being performed. If a deep nasofrontal angle should not be brought forward, reduction of the brow may be indicated. If the nasofrontal angle should not be retrodisplaced to deepen a shallow angle, brow augmentation may prove helpful in separating the nose from the forehead or in making the nose appear shorter in the vertical dimension. Augmentation and reduction browplastic techniques are discussed, and selected methods are illustrated. Some involve additional resection of frontal bone or procerus muscle at the time of nasal-hump removal. Others employ grafts of bone and/or cartilage removed from the nose at the time of septorhinoplasty. The versatile aesthetic surgeon should be capable of changing all structures adjacent to the nose. Certain difficult cosmetic problems are best treated by directing appropriate attention to these structures and to the nose rather than by concentrating on the nose alone. That the brow is one of these important abutting landmarks is demonstrated.
Importance of the columellar-labial junction in rhinoplasty.
Concentration on tip positioning may draw a surgeon's attention away from modifying positions of the nasofrontal angle and of the columellar-labial junction. All three landmarks are, however, vital to the establishment of desirable profiles. This article emphasizes that changes in the positioning of the columellar-labial junction may (1) eliminate certain hazards involved in changing tip position, (2) make it possible to produce aesthetic effects that cannot be achieved with tip positioning alone, and (3) make rhinoplasty safer and more predictable in certain difficult cases. Also presented are techniques that have been found to work most satisfactorily in changing angle and position. A few patients selected from among several thousand rhinoplastic cases are analyzed to underscore the significance of this area in rhinoplastic planning. Follow-up varied from several months to several years.
Anatomy of the superficial temporal artery.
The anatomy of the superficial temporal artery was investigated in radiographic and cadaveric studies. The superficial temporal artery divides into an anterior and posterior branch, and the diameters of these vessels are similar. The anatomy of these two vessels is described, and implications for their use in reconstructive flaps are suggested.
Squamous cell carcinoma of the base of the tongue.
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