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Biomedical subjects

W K Wright

Publications and source records attributed to W K Wright.

At least 19 recordsLinked to original sources
PubMed1989

Advances in nasal tip surgery. The lateral crural steal.

Increasing nasal tip projection, rotation, and definition have classically been attempted through a variety of lobular cartilage incising or excising techniques. Resultant long-term complications, including bossing, alar notching, pinched tips, and alar collapse, have occasionally resulted from the use of these techniques. The majority of these complications have arisen secondary to a loss of structural support following the interruption of the lower lateral cartilages. This article describes the "lateral crural steal," a method of increasing nasal tip projection and nasal tip rotation while preserving the integrity of the lobular cartilage complex. The procedure uses the external rhinoplasty approach for exposure. By elevating both the dorsal and the vestibular skin from the domes of the lobular cartilages, the lateral crura may be advanced onto the medial crura to further project the nasal tip and to reorient the tip upward. This technique along with its philosophy and long-term follow-up results are presented.

Follow-Up Studies↗
PubMed1987

The physician assistant as forensic investigator.

Physician assistants are employed as forensic investigators at the Office of the Medical Examiner, Suffolk County, New York. We describe the educational qualifications of physician assistants and their valuable role in forensic medicine in Suffolk County.

Forensic Medicine↗
PubMed1986

Septal perforation closure utilizing the external septorhinoplasty approach.

Nasal septal perforations can be technically difficult to close permanently, particularly if they are large, located posteriorly, or associated with little residual septal cartilage and bone. By allowing direct access to the usually undisturbed dorsal septum, septal flaps are easier to elevate with the external septorhinoplasty approach. Also, better visualization and more room in which to work are afforded by this approach, enabling the surgeon to close perforations that might be more technically difficult to close using standard intranasal incisions. The technique of external septorhinoplasty combined with septal mucoperichondrial advancement flaps and a supporting graft of mastoid periosteum, cartilage, or ethmoid bone was used to close perforations up to 4 cm in diameter in 22 patients from 1981 to 1983 with a 77% (17/22) complete closure rate. Symptomatic improvement was noted by all patients.

Humans↗
PubMed1980

Effect of off-vertical tilt and macular ablation on postrotatory nystagmus in the squirrel monkey.

The slow phase eye velocity (SPEV) and duration of post-rotatory nystagmus (PRN) were studied in squirrel monkeys (Saimiri sciureus) after a ramp speed rotation (0-200 degrees/sec, with 1 degree/sec2 angular acceleration). When the results were compared between straight upright vertical rotation, 9 degrees tilt rotation, and 18 degrees tilt rotation, faster decay both in SPEV and in duration was found in the tilt rotation situations. Difference in nystagmic decay curves by tilting rotation axis could be from the convergence of macula-semicircular canal inputs. Subsequently bilateral macular ablation (two-stage) was performed. The difference in nystagmus decay curves between three different rotations was reduced; therefore, the change of gravity direction perceived through gravity receptors other than macular endorgans was minimal and did not produce a difference in three different rotations.

Acoustic Maculae↗
PubMed1977

Effect of otolith end organ ablation on pendular rotation nystagmus in squirrel monkeys.

Damped pendular rotation nystagmus was studied in squirrel monkeys before and after otolith end organ ablation (two-stage operations). After each operation, the nystagmic slow phase eye speed toward the operated side was reduced (to about 73% of that before the operation) and that to the non-operated side did not show any marked change. A few subjects showed spontaneous nystagmus with amphetamine administration but only in dark (could not be found in light) immediately after the operation, and it disappeared rapidly. Therefore, this post-ablative reduction of the slow phase eye speed is considered to result from the loss of inputs from the otolith end organs.

Amphetamine↗
PubMed1977

Regeneration of cartilage in the monkey auricle after subperichondrial resection.

Cartilage regeneration was histologically evaluated in vivo in the squirrel monkey pinnae. Only 2 of 11 ears exhibited evidence of cartilage regeneration (Movat stain) within the subperichondrial area, eight to nine weeks postoperatively. The present experimental results in squirrel monkeys contradict the previously reported high incidence of ear cartilage regeneration in young rabbits and may reflect a difference in surgical technique, animal species, or animal age.

Animals↗
PubMed1977

Management of otitic cholesteatomas.

When otitic cholesteatomas are removed by a surgical method that preserves or reconstructs the bony canal wall and tympanic membranes, there is a risk of imcomplete removal and possible regrowth of the lesion. To study the incidence of this complication, 52 patients with cholesteatoma had elective repeaated explorations at various postoperative intervals; eight (15.4%) had early cholesteatoma regrowth even though there was no clinical evidence of it. Seven of these regrowths were small and were again srugically removed. It is advocated that conservative surgery for cholesteatoma be followed up in two years by another elective surgical exploration to check for and dispose of possible cholesteatoma regrowth. This would provide safety comparable to that achieved with radical mastoidectomy, with far better function and hearing. The method does necessitate patient understanding and cooperation and I suggest methods of achieving this.

Aged↗
PubMed1977

Regeneration of nasal skeletal structures after subperiosteal and subperichondrial resection.

The degree of regeneration of nasal structures after surgical resection was evaluated in six mongrel dogs that underwent selective resection of the nasal bones and upper lateral cartilages. Preservation of the periosteal and periochondrial flaps was accomplished during the resection. In several cases, different tissues were interposed between the flaps before their closure. The dogs were killed at two-and eight-month intervals after the original resections. No evidence of new cartilage regeneration was found on microscopic evaluation in the region of the resected upper lateral cartilages. Minimal new bone foci were noted at the edge of the resected nasal bones in three of the cases. The findings failed to support any significant degree of nasal structure regeneration after resection.

Animals↗
PubMed1976

Effect of vestibular deafferentation upon positional nystagmus in the squirrel monkey.

Seventeen of eighteen squirrel monkeys, under a restrained condition, showed positional nystagmus in different body positions. Good repeatability and consistency of the nystagmus were found, especially at the left-lateral, right-lateral, and head-hanging positions. Positional nystagmus was not observed after the subject underwent bilateral labyrinthectomy. However, one subject in which part of the crista ampullaris posterior remained, continuously showed a positional nystagmus. Therefore, the existence of a minimal vestibular imput from the crista ampullaris could provoke the nystagmus. Some changes occurred in positional nystagmus after bilateral macular ablation; however, the nystagmus did not completely disappear. Even though imput from the crista ampullaris is essential to provoke positional nystagmus in squirrel monkeys, the positional nystagmus probably results from a central dyscoordination between vestibulo-oculomotor function, spino-oculomotor function, vestibular and brain circulation, and psychological condition.

Animals↗
PubMed1976

Symposium: Methods of reconstruction in tympanoplasty. IV. Conchal perichondrium as a tympanic graft with maintenance of drum conization.

Tympanoplasty reconstruction of the eardrum approached normal anatomy and function with the use of connective tissue to replace the substantia media. Perichondrium taken from the concha is preferred because it lies flat and is easy to manipulate. Grafts placed on the outer surface of the remnant tend to lateralize with loss of drum conization. Grafts placed on the undersurface of the remnant do not have this disadvantage.

Connective Tissue↗
PubMed1976

Damped pendular rotation nystagmus after unilateral labyrinthectomy or unilateral lateral semicircular canal block in squirrel monkeys.

Using a damped pendular rotation table, which provided an oscillation of 15.5 sec, per-rotatory nystagmus, was evaluated in six squirrel monkeys that underwent unilateral labyrinthectomy and five that underwent unilateral lateral semicircular canal block, both pre- and postoperatively. The bidirectional summation of the nystagmic slow-phase eye speed after unilateral labyrinthectomy and after unilateral lateral semicircular canal block showed similar reduction to about 60 per cent of the values obtained in the pre-operative status. Under the present test situation, both slow-phase eye speed and number of nystagmic beats in the monkeys after unilateral lateral semicircular canal block were larger by the ampullopetal stimulation than those evoked by ampullofugal stimulation. The relation between slow-phase eye speed and number of beats showed similar tendency when we compared pre-operative controls and the group after unilateral lateral semicircular canal block, but the monkeys after unilateral labyrinthectomy depicted different tendencies.

Animals↗
PubMed1975

A psychological study of patients undergoing cosmetic surgery.

This is an investigative study of the personality of patients requesting cosmetic rhinoplasty. Analysis of data obtained from objective projective tests and psychological interviews indicated that patients seeking cosmetic surgery are not as psychologically disturbed as often as described. Comparative studies showed certain personality characteristics to be associated with patients who seek cosmetic surgery. While evaluations 18 months after surgery showed no major personality change, self-concept was improved. Certain disturbing personality patterns indicative of psychological risk were identified. These fell more in the range personality disorders, exemplified by the infantile-narcissistic and the manipulative controlling personalities rather than in somatic ranges. We recommend a simple interview question method of counseling designed to identify underlying psychological manifestations and to control the potential problem patient.

Adolescent↗