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The surgical correction of gynecomastia
481
ABSTRACTS
with improvement by 1-2 years of age. The stridor is inspiratory with normal voice and cry. Symptoms disappear in sleep, but are aggravated by crying, and are louder when patient is on his back as compaired to the prone position. The most common cause of congenital inspiratory strider is laryngomalacia, or abnormal collapse of supraglottic tissue on inspiration. The epiglottis is elongated or abnormally curved, or there are redundant arytenoepiglottic folds, The causes of stridor are as follows: (1) Supraglottic (congenital laryngeal stridor. micrognathia with glossoptosis, supraglottic webs, lingual thyroid or cyst). (2) Glottic causes (laryngeal weh or polyp, vocal cord palsy, cleft larynx, foreign body, birth injury to cricothyroid). (3) Infraglottic [congenital subglottic stenosis, tracheomalacia, angioma or neurofibroma below cords, vascular ring, mediastinal tumor, foreign body). Inspiratory stridor is usuahy supraglottic in origin, while expiratory stridor is usually secondary to infraglottic causes, and a weak or hoarse voice is associated with glottic pathology. Complete investigation of all infants with congenital stridor should include laryngoscopy, lateral neck X-rays, and barium swallow may also be necessary.IV. Gilbert. THORAX THE SURGICAL CORRECTION OF GYNECOMASTIA. G. Letterman and M. &hurter. Amer. Surg. 35:322-325 (May), 1969.
There are six important components of the operation as advised by the authors: (1) Superior semicircular intra-areolar incision. (2) A thick areolar flap. (3) Breast and fatty tissues removed through the intraareolar incision. (4) Preservation of adequate mammary fullness by beveling of the edges of resection. (5) Suction drainage. (6) Closure of the incision with superior flap advancement of the areola in those cases where it is necessary to minimize overhanging of the nipples. Sutures are placed subcuticularly.-A. M. Salzberg. FUNNEL CHEST-OPERATIVE METHOD AND LATE RESULTS. M. Sulamaa and E. I. Wallpren. Z. Kinderchir. 8:22-52, 1970.
This is a study of 418 cases, of whom 407
were treated by the authors’ own method. Forty-three children treated in the years 1958 and 1959 are selected for special examination. The sternum is mobilized by bilateral subperichondrial resection of cartilages in the region of the funnel, and a transverse metal bar is inserted for fixation. Early operation in the first and second year of life is recommended to reduce the operative risk. Using this procedure, of 43 children re-examined between 7 and 9 years after operation, there were good results 28 times. In 12 the result was satisfactory and in one case it was bad.-S. Hofmann arid H. B. Eckstein. MANAGEMENT OF A LARGE FOREIGN BODY IN THE MEDIASTINUM OF A CHILD. D. B. Groff, S. Stool and D. G. Johnson. Amer.
Surg. 35:630-634
(September),
1969.
A case history is reported in which a large tack was swallowed and proceeded to migrate from the esophagus into the trachea and thence into the mediastinum. Despite a tracheostomy and fluoroscopic assistance, the tack could not be removed by bronchoscopy. A trachea-esophageal fistula developed after thoracotomy to remove the tack. The fistula was closed 8 weeks after diagnosis. It is suggested that with such large foreign bodies, removal should not be attempted by persistent endoscopy, but should be accomplished by thoracotomy.A. M. Salzherg. THYMECTOMY FOR MYASTHENIA GRAVE IN BANTU CHILDREN. J. Geefhuyserl. M. Ronthal and M. A. Rogers. S. Afr. Med.
_I. 44:239-241
(February
28),
1970.
Myasthenia gravis is rare in children and is even less often seen in the African than the Caucasian. At Baragwanath Hospital, the largest hospital in Africa. only four cases have been seen in children in the past 14 years. This paper discusses three of these cases. which could not be controlled medically. Two of the children were 5 years of age and the third 4. Each was subjected to thymectomy through a sternotomy incision. Each child had an immediate complete remission of symptoms but there was recurrence within 48 hours. Each was controlled postoperatively on a lesser dose of medica-
ABSTRACTS
with improvement by 1-2 years of age. The stridor is inspiratory with normal voice and cry. Symptoms disappear in sleep, but are aggravated by crying, and are louder when patient is on his back as compaired to the prone position. The most common cause of congenital inspiratory strider is laryngomalacia, or abnormal collapse of supraglottic tissue on inspiration. The epiglottis is elongated or abnormally curved, or there are redundant arytenoepiglottic folds, The causes of stridor are as follows: (1) Supraglottic (congenital laryngeal stridor. micrognathia with glossoptosis, supraglottic webs, lingual thyroid or cyst). (2) Glottic causes (laryngeal weh or polyp, vocal cord palsy, cleft larynx, foreign body, birth injury to cricothyroid). (3) Infraglottic [congenital subglottic stenosis, tracheomalacia, angioma or neurofibroma below cords, vascular ring, mediastinal tumor, foreign body). Inspiratory stridor is usuahy supraglottic in origin, while expiratory stridor is usually secondary to infraglottic causes, and a weak or hoarse voice is associated with glottic pathology. Complete investigation of all infants with congenital stridor should include laryngoscopy, lateral neck X-rays, and barium swallow may also be necessary.IV. Gilbert. THORAX THE SURGICAL CORRECTION OF GYNECOMASTIA. G. Letterman and M. &hurter. Amer. Surg. 35:322-325 (May), 1969.
There are six important components of the operation as advised by the authors: (1) Superior semicircular intra-areolar incision. (2) A thick areolar flap. (3) Breast and fatty tissues removed through the intraareolar incision. (4) Preservation of adequate mammary fullness by beveling of the edges of resection. (5) Suction drainage. (6) Closure of the incision with superior flap advancement of the areola in those cases where it is necessary to minimize overhanging of the nipples. Sutures are placed subcuticularly.-A. M. Salzberg. FUNNEL CHEST-OPERATIVE METHOD AND LATE RESULTS. M. Sulamaa and E. I. Wallpren. Z. Kinderchir. 8:22-52, 1970.
This is a study of 418 cases, of whom 407
were treated by the authors’ own method. Forty-three children treated in the years 1958 and 1959 are selected for special examination. The sternum is mobilized by bilateral subperichondrial resection of cartilages in the region of the funnel, and a transverse metal bar is inserted for fixation. Early operation in the first and second year of life is recommended to reduce the operative risk. Using this procedure, of 43 children re-examined between 7 and 9 years after operation, there were good results 28 times. In 12 the result was satisfactory and in one case it was bad.-S. Hofmann arid H. B. Eckstein. MANAGEMENT OF A LARGE FOREIGN BODY IN THE MEDIASTINUM OF A CHILD. D. B. Groff, S. Stool and D. G. Johnson. Amer.
Surg. 35:630-634
(September),
1969.
A case history is reported in which a large tack was swallowed and proceeded to migrate from the esophagus into the trachea and thence into the mediastinum. Despite a tracheostomy and fluoroscopic assistance, the tack could not be removed by bronchoscopy. A trachea-esophageal fistula developed after thoracotomy to remove the tack. The fistula was closed 8 weeks after diagnosis. It is suggested that with such large foreign bodies, removal should not be attempted by persistent endoscopy, but should be accomplished by thoracotomy.A. M. Salzherg. THYMECTOMY FOR MYASTHENIA GRAVE IN BANTU CHILDREN. J. Geefhuyserl. M. Ronthal and M. A. Rogers. S. Afr. Med.
_I. 44:239-241
(February
28),
1970.
Myasthenia gravis is rare in children and is even less often seen in the African than the Caucasian. At Baragwanath Hospital, the largest hospital in Africa. only four cases have been seen in children in the past 14 years. This paper discusses three of these cases. which could not be controlled medically. Two of the children were 5 years of age and the third 4. Each was subjected to thymectomy through a sternotomy incision. Each child had an immediate complete remission of symptoms but there was recurrence within 48 hours. Each was controlled postoperatively on a lesser dose of medica-