Gilbert B. Snyder

Combined intracranial-extracranial approach and use of the two stage split flap technic for reconstruction with craniofacial malignancies

Abstract The combined intracranial-extracranial approach to craniofacial malignancies has been performed in thirteen patients. In these cases there has been reconstruction of the exposed vital parts using the two stage split flap technic or occasional split thickness skin grafts. There were no postoperative deaths in spite of extensive preoperative residual carcinoma and massive resections. The patients were rehabilitated more rapidly due to immediate reconstruction which we believed did not jeopardize their subsequent course. The combined approach is most useful in attempting to cure cancer, to palliate the pain and dysfunction of cancer and, to diagnose the extent of cancer progression.

Surgical Treatment of Congenital Thumb Deformities (including Psychological Impact of Correction)

Eleven Patients with major contgenital deformities of the hand are presented. Seven index-finger tranpositions are described and the use of this operation is urged for absent or floating thumb. The operative technique is described in detail, and a discussion of the timing of surgery, associated anatomical defects, and the psychological impact of these deformities on the children is presented. A successful operation for the management of congenital subluxations of the thumb is described. Evidence suggests that hand surgery for this deformity should be undertaken at an earlier age than has been custom in past years.

A new chin implant for microgenia.

We describe our experiences with a new silicone bag-gel chin implant, developed in two phases over a 4-year period. Fifty patients received the Phase I implant, and such complications as internal and external soft tissue erosion, indentation, slippage, asymmetry, infection, andd late bone resorption (two cases) were seen. Subsequently 28 patients received the Phase II implant, and have been followed up to one year. So far, the only complication has been asymmetry in one case.

Plug-in kidneys for dialysis of uremic dogs

Abstract Twenty-one plug-in kidneys were used to dialyze thirteen dogs. Blood urea nitrogen levels were successfully lowered in three fourths of the animals either on the first or second perfusions. Perfusions were carried out for one to seven hours. Grafts functioned better when preperfusion blood urea nitrogen levels were higher. Larger kidneys from male donors appeared to work best. Of twenty-one homografts, ten were rated good, five were fair, and six were poor. Graft results on the second perfusion were never the same as they were on the first. Until further research is done the variability of graft performance seems to preclude the short-term use of extracorporeal kidneys as a safe and effective means clinically to combat chronic uremia. As a laboratory test model, however, the plug-in kidney would permit parameters of study of histopathology, arteriovenous differences, and renal functioning which could be monitored serially with comparative ease. In addition, the active pathologic, biochemical, physiologic, and immunologic processes are much easier to observe. For these reasons the use of the ex vivo kidney has great potential in experiments.