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Biomedical subjects

W H Friedman

Publications and source records attributed to W H Friedman.

At least 19 recordsLinked to original sources
PubMed1992

Palatal extension of middle meatal antrostomy.

The palatine bone is an important posterior landmark in the performance of ethmoidectomy. This usually unrecognized structure forms the posterior one third of the lateral nasal wall. Resection of a portion of the palatine bone completes the marsupialization of the sphenoethmoidal recess and medial maxilla. It is a major landmark for localization of the sphenopalatine artery at its entrance into the nose. Middle meatal antrostomy is enhanced by removal of the part of the palatine bone that forms the posterior medial wall of the maxillary sinus. In 1110 consecutive sphenoethmoidectomies, marsupialization of the maxillary sinuses has included partial removal of the perpendicular plate of the palatine bone. Patency has been maintained in all of these antrostomies. Pertinent anatomy and surgical technique are reviewed.

Humans↗
PubMed1992

Transantral revision of recurrent maxillary and ethmoidal disease following functional intranasal surgery.

Recurring disease in the maxillary sinus, despite inferior meatal antrostomies, has led to the widespread use of middle meatal antrostomy or simple decompression of the natural ostium of the middle meatus in attempts to restore function to the maxillary sinus. We have reported recurrent disease in the maxillary sinus in patients with stage III or stage IV hyperplastic rhinosinusitis in whom attempts at functional surgery of the middle meatus were unsuccessful in reversal of retrograde changes. One hundred patients who had previously undergone intranasal sphenoethmoidectomy with removal of the middle turbinate, decompression of the maxillary ostium, and removal of overt hyperplastic disease of the middle meatus underwent revision transantral ethmoidectomy. All recurrent or residual diseased mucosa was removed, including polyps, occasional mucoceles, and hyperplastic changes that occurred despite patency of a middle meatal maxillary ostium. In many of these patients the maxillary sinus was widely marsupialized secondarily into the posterior nasal vault. While the initial overall polyp recurrence rate after intranasal sphenoethmoidectomy in these patients was as high as 19.2%, the rate of polyp recurrence after transantral revision was less than 5% in from 18 to 48 months postoperatively. The experience in this series suggests that mucosal changes have played a primary role in unsuccessful treatment, independent of whether or not adequate functional egress for maxillary secretion, drainage, or ventilation has been created or restored.(ABSTRACT TRUNCATED AT 250 WORDS)

Ethmoid Sinus↗
PubMed1979

Ectropion after blepharoplasty. Experimental and clinical observations.

Ectropion, or eversion of the lower lid, is the most common serious complication of blepharoplasty. Although many factors can be related to the production of this phenomenon, excess tension on the suture line has been implicated as a causal factor in the past. Because of the lack of instrumentation for measuring suture line tensions during the performance of blepharoplasty, and the relative difficulty in identifying suitable animal models, there has been little investigation of excess suture line tension as a cause of ectropion. This study was designed to establish a technique for measuring suture line tension during the performance of blepharoplasty and evaluating the effects of excessive suture line tension in the experimental production of ectropion in the stump-tailed monkey. In both monkey and human eyelid excisions, suture line tension is evaluated with the use of a fine-balance dynamometer. Suture line tension is shown to be a measurable parameter, and the technique of measurement is described. Excessive suture line tension has been demonstrated in monkeys and humans to be a causal factor in the production of ectropion following eyelid excisions.

Animals↗
PubMed1979

Workshopping.

Explore the source record for details and available documents.

Education, Nursing, Continuing↗
PubMed1978

Computer tomography of the larynx.

Evaluation of computed tomography of the normal larynx has been performed utilizing corresponding tomographic and anatomic planes. The transaxial, coronal, and sagittal planes have been evaluated. While all three planes have distinct potential diagnostic value, the transaxial plane offers a unique view of laryngeal structures not afforded by any other technique. It is hoped that diagnostic criteria developed in this study will prove applicable to the evaluation of clinical laryngeal disease.

Humans↗
PubMed1978

Evaluation of laryngeal cancer by computed tomography.

Six cases of laryngeal cancer have been examined by computed tomography. The findings were correlated with those obtained by laryngoscopy and in five cases by pathological examination of the surgical specimens. Computed tomography accurately delineated the extent of tumor involvement of the laryngeal and paralaryngeal soft tissues. The diagnosis of involvement of the laryngeal cartilages presents some problems, which are discussed.

Aged↗
PubMed1978

Group therapy in family medicine: part 1.

Group psychotherapy may often be the treatment of choice for patients whose somatic symptoms are a reflection of interpersonal difficulties which are not of sufficient magnitude to warrant referral to a mental health professional. This type of treatment can be offered in the context of family practice, with benefit to both patient and physician. The physician may function as co-therapist with a more experienced group leader; it is essential, also, that competent supervision be available. Such a group was established in a family practice center; it met for 20 weekly sessions. Patient improvement ranged from minimal to considerable; in addition, the frequency of visits to the Center for essentially non-medical reasons decreased considerably, with the greatest decrease in such visits occurring 6 to 15 months after termination of group treatment. This is the first part in a four-part series dealing with group therapy in family medicine.

Adult↗
PubMed1978

Group therapy in family medicine. Part 2: establishing the group.

This paper is the second in a four-part series and describes some of the prerequisites necessary for the establishment of a therapy group in family medicine. In setting up a group, it is necessary to have group leadsers, a supervisor, patients, a suitable room, and time set aside for the purpose. Referral sources and criteria for referral are presented, as well as a description of patient characteristics. Factors leading to referral are discussed, and contraindications for referral considered.

Family Practice↗
PubMed1978

Group therapy in family medicine. Part 3: starting the group.

This paper is the third in a four-part series and in it some issues and techniques pertaining to the pregroup screening interview are discussed as well as the initial meeting of a therapy group in a family practice setting. The screening interview enables patient and group therapists to decide whether or not the patient might benefit from group therapy. Topics covered in such an interview are discussed. Some ways of beginning and of ending the first session are described.

Family Practice↗
PubMed1978

Group therapy in family medicine: part 4: a case report.

This paper is the last of a four-part series and presents a case report of a patient who attended a 20-week course of group therapy in a family practice. She was a patient who identified herself as medically, but not psychiatrically, sick. She was appropriately investigated and referred within the practice for assessment of her suitability for group therapy. Her course of treatment is described and explained. The satisfactory outcome of this case suggests that there may be a place in a busy family practice for referral of this type of patient.

Abdomen↗
PubMed1975

Repair of extended laryngotracheal stenosis.

The most challenging laryngotracheal stenosis are those that exceed 5 cm in length and involve more than one area of the larynx and trachea contiguously. A successful technique for the repair of these injuries with a three-stage laryngotracheal trough was created followed by anterior tracheal wall replacement with a skin-Marlex-muscle pedicle flap.

Adult↗
PubMed1975

Evaluation of nasal tip surgery.

Nasal tip surgery has been evaluated with respect to correction of the lower lateral cartilages. Indications, techniques, results, and complications related to three generic approaches to the lower lateral cartilages are described. In 673 consecutive rhinoplasties the commonest type of nasal tip surgery was excisional, utilizing either a marginal or cartilage splitting technique. These techniques were utilized: 1. to accomplish debulking, and 2. to accomplish the installation of facets. The excisional technique found its greatest utility in primary rhinoplasties. The version technique, utilizing a change of direction of the thrust of the lower lateral cartilages was utilized in a variety of situations, particularly for the correction of moderately congenitally hypoplastic tip cartilages. It also found great utility in surgery of the Negro or cleft palate nose, increasing tip projection, correcting unacceptable bifidity, and in revision rhinoplasty. Augmentation rhinoplasty, utilizing conchal cartilage as an elastic strut was particularly useful for severe hypoplastic cartilage deficits, the Negro nose, columellar retraction, and alar rim deficits. The overall complication rate of lower lateral rhinoplasty was 17.4 percent. The rate of unacceptable complications related to lower lateral rhinoplasty was 2.7 percent.

Evaluation Studies as Topic↗
PubMed1975

Surgery for chronic hyperplastic rhinosinusitis.

Davison pointed out in 1953 that his purpose in treating sinusitis was to utilize the smallest amount of surgery that would produce permanent relief of symptoms. By 1963 he had become convinced that extensive disease required extensive surgery. Hyperplastic rhinosinusitis is treated by a variety of surgical techniques including polypectomy, turbinate cautery, submucous resection of the turbinates or nasal septum, anterior ethmoidectomy, and spheno-ethmoidectomy. Sixty-eight patients are presented who have undergone bilateral sphenoethmoidectomy between January, 1969, and January, 1974. These patients were predominantly allergic, with a high percentage of previous polypectomies and desensitization which failed to control their recurring nasal polyps. Ten patients were lost to follow-up. Forty-seven of 68 patients have had no recurrence of polyps in from 12 to 60 months. All patients continued to have mucosal manifestations of allergy or infection, but the recurrence of late polyps was limited to 11 patients. The spheno-ethmoidectomy technique is utilized, stressing complete removal of the middle turbinate. Kidder has shown an improved rate of polyp control in patients following ethmoidectomy with middle turbinate removal rather than with partial or total preservation of the middle turbinate. Complete resection of the middle turbinate with opening of the sphenoid air sinus permits a thorough exenteration of the ethmoid labyrinth and better control of chronic disease. A complication rate of 5.9 percent is presented and is deemed acceptable, since there no disabling complications or complications related to poor visualization.

Chronic Disease↗