Operative stabilization of nonpenetrating chest injuries

ABSTRACTS

278

Once this problem was recognized the mother was separated from the children and underwent intensive psychotherapy. The columella lesions were then reconstructed.--Anthony B. Sokol

graphic analysis of the LVPM ing retrodisplacement.-Anthony

THORAX Operative

Fastening

the Base of the Tongue

the Hyoid

for Relief

of Respiratory

to

Chest Injuries.

Distress

in

Thorac 1975.

Syndrome. A. Lopidot and M. BenHur. Plast Reconstr Surg 56:89-91 (July), 1975.

An illustrative case report and new technique is presented for the early treatment of the respiratory complication associated with the Pierre Robin Syndrome. The technique described, fixes the posterior tongue (fibrous portion) anteriorally and inferiorally, thereby preventing the respiratory stridor. A stainless steel wire suture is used to ligate the tonue to the hyoid bone. The advantages of this technique apparently are two: (I) Lack of limitation of tongue movements. (2) An absence of wound breakdown. A brief review of the available techniques for prevention of respiratory complications of the Pierre Robin Syndrome are given. The disadvantages of each as compared to this new technique are reported.--d. E. Sokol

and

Use

of

Pharyngeal

Insufficiency.

levator

Flap

for

Retrodisplacement Congenital

Palate

1. C. fisher and M. T. Edgerton. Cleft

Palate J 12:270-273

(July), 1975.

Cleft palate is associated with abnormal insertion of the levator veli palatini muscle (LVPM) into the posterior border of the shortened hard palate. In addition, the longitudinal portion of the palatopharyngeus muscle is displaced laterally. A retrodisplacement of the LVPM should not only improve the axis of this muscle but aid in speech and hearing disorders associated with the cleft. The use of the retrodisplacement alone especially with the foreshortened palate is not advocated due to the high incidence of postoperative hypernasality. A superior based pharyngeal flap in association with &he levator retrodisplacement is advocated in these cases. The authors report that the surgical procedures should provide adequate static reduction of the velopharyngeal space. They state that possibly an achievement of dynamic control of the nasal air escape through each lateral port during active phonation could be achieved. The second goal however. can be proven only with continued clinical assessment of the speech improvement following surgery and electromyo-

of

Nonpenetrating

B. P. Moore and

Cordiovasc

Surg

H. C. Grille. J 70:619-630 (October),

Of I I2 patients with moderate to severe blunt injury to the chest, 50 were treated by operative stabilization of the chest wall by pinning of the ribs. Tracheostomy and ventilatory support were therefore avoided in all but eight patients. There were I I deaths. The importance of stabilization of the chest wall is emphasized. The patient material would indicate that this approach without ventilatory support is satisfactory for most patients. No objective comparison with orher forms of therapy is presented. In discussion of this paper J. Kent Trinkle proposed treating these patients for lung contusion without therapy for the flail chest. 30 patients so treated faired better than 30 comparable patients treated by tracheostomy ventilatory support.-Thomas M. Holder Distribution

Combined

Stabilization

Forward

Pierre Robin

function followB. Sokol

of Thymic

Tissue

Current

Procedures

Mediastinum.

in the

and

Anterior

in Thymectomy. A. Mosooko, Y. Nohooko and Y. Kotoke. J Thorac Cordiovasc Surg 70:747-754 (October), 1975. Eighteen patients (adults) having thymectomy for myasthenia gravis are presented. In I; there was histologic evidence of thymus beyond the thymic capsule. If a total thymectomy is to be done, therefore, it is recommended that the fatty tissue adjacent to the thymus in the anterior, superior mediastinum and in the neck be removed in the resection.-Thomas M. Holder

HEART Congenital

AND GREAT

Cardiac Anomalies,

pair in Infancy.

VESSELS One-Stage

Re-

D. 8. Doty, R. M. lauer, and J. L.

Ehrenhoft. Ann Thoroc Surg 20:316-325

(Septem-

ber), 1975. A series of 74 patients undergoing open intracardiac repair of congenital heart lesions in the first 2 yr of life are presented. The authors’ hypothesis is that if all patients who present in this age range were to undergo total corrective surgery rather than palliation the results would be quite acceptable. Yet the essence of their paper is that there are certain patients who are better off excluded from open intracardiac repair in the first year of life. These notable