Congenital lesions of the head and neck. Introduction.
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Biomedical subjects
Publications and source records attributed to W E Davis.
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An orbital teratoma with extension into the maxillary sinus, pterygopalatine fossa nasal cavity, and middle cranial fossa is presented. Through combined efforts of the services of Ophthalmology, Otolaryngology, and Neurosurgery, a tumor that was 4.5 cm in greatest diameter was removed, leaving the globe and optic nerve within the orbit. Within the 2 1/2-year period since surgery, the condition of the patient has been satisfactory.
Electromyographic examination of a left Gillies fan flap 29 months after operation and of a right Abbe-estlander flap 17 months after operation showed complete motor innervation of both.
Electromyography of the intrinsic laryngeal muscles has not been widely used, partly because of the difficulty of accurate insertion and stabilization of existing electrodes. The sampling portion of our original electrode has been redesigned. Two needle electrodes, 4 mm in length, protrude from a truncated coneshaped, nonconducting body that has been fashioned to sit in the laryngeal ventricle. The depth of insertion is controlled, and the device resists accidental extrusion.
Presently available equipment for nerve stimulation includes the relatively expensive multifunction pulse generators and the disposable dc stimulators. We have designed a semidisposable, two-transistor pulse generator that is portable, inexpensive, and capable of dynamic nerve stimulation.
Previous research has indicated that ability-oriented organicity tests are of limited value in the separation of brain-damaged from schizophrenic patients in psychiatric hospitals. In the present study the capabilities of nine ability test measures and the MMPI Depression scale to differentiate organics from depressives were evaluated. Only six of the nine ts used to evaluate the differences between the two groups were significant at the 0.5 level and, after the samples were levelled for age, education and IQ, the number fell to zero. In contrast, the Depression scale differences were highly significant both before and after levelling. Multiple correlations run to evaluate the use of personality and ability measures in combination showed that they had considerable promise and suggest that the separation of organic from functional psychiatric hospital groups is best achieved by such combinations.
Used the Henmon-Nelson Test of Mental Abilities to predict WAIS Full Scale IQ Scores with a group (N = 41) of hospitalized alcoholics. The results suggest a moderately high correlation (r = .807), which corresponds with reports of these studies of Watson and Klett for a group of hospitalized psychiatric patients. A linear regression was calculated and a and b weights generated.
Peripheral lymphocytes from 12 patients with squamous cell carcinoma of the lead and neck were incubated with autologous tumor explants. Four of the 12 patients demonstrated lymphocyte induced tumor cytotoxicity. These lymphocytes adhered to the tumor cells and deposited a radioactive label from their surface onto tumor cells. The deposition of this label was associated with tumor death. Tissue sections from those patients who demonstrated lymphocyte cytotoxicity showed a marked plasmacytic infiltration. This was in contrast to non-responders where only a desmoplastic tissue response was observed with few inflammatory cells.
An instance of massive hemorrhage following transtracheal aspiration with successful resuscitation is reported. Indications for the procedure are pneumonia with poor ability to produce sputum, fever, or pulmonary infiltrate in a stuporous patient, and facial injuries which would complicate nasotracheal suction. The cricothyroid membrane is recommended as the site of entry. If airway hemorrhage does occur, immediate maintenance of the airway and tamponade of the bleeding can aid in successful resuscitation of the patient.
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The relationship between psychiatric patients' psychological test responses and their religion has been overlooked in the past. MMPI protocols were obtained from samples of 18 Roman Catholic schizophrenic, 18 Protestant drug-dependent male patients. The profiles reflected significant religion related differences in scales L, HY, D; MF, PA and SC. The results suggest that the religion of the psychiatric patient is a potentially important S variable that could influence the psychiatric diagnosis and subsequent treatment.
Parotid fistula is most commonly a posttraumatic situation. In posttraumatic cases, spontaneous closure of the fistula is the general rule. Conservative approaches to the occurrence of a parotid fistula are eliminating oral intake by the patient and applying a pressure dressing while maintaining nutrition by the intravenous route. Anticholinergic drugs decrease the production of saliva and thus would appear to be beneficial. When a parotid fistula does not heal under these conditions, then more aggressive treatment is indicated. Treatment should be based on whether the fistula is ductal or glandular in origin. Several methods of treatment have been advocated in the past. Low dose radiotherapy has been mentioned by some authorities as the treatment of choice for parotid fistula. This was used in one of our patients without response. Excision of the fistulous tract with ligation of the parotid duct has been advocated by some authorities. Tympanic neurectomy appears to be a satisfactory method of dealing with selected parotid duct fistulas, and glandular fistulas are best treated by tympanic neurectomy. Suppression of parasympathetic activity by the use of tympanic neurectomy has been said on some occasions to be transient (for example, Frey's syndrome). In dealing with parotid fistulas it would not appear to matter whether the effects are transient or permanent. The suppression of activity by tympanic neurectomy lasts long enough to allow for healing of the fistulous tract and relief of symptoms.
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