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Biomedical subjects

A Samit

Publications and source records attributed to A Samit.

15 recordsLinked to original sources
PubMed1999

Mandibular subluxation for distal internal carotid exposure: technical considerations.

PURPOSE: Carotid endarterectomy (CEA) has become one of the most commonly performed vascular procedures, because of the beneficial outcome it has when compared with medical therapy alone and because of the anatomic accessibility of the artery. In cases of distal carotid occlusive disease, high cervical carotid bifurcation, and some reoperative cases, access to the distal internal carotid artery may limit surgical exposure and increase the incidence of cranial nerve palsies. Mandibular subluxation (MS) is recommended to provide additional space in a critically small operative field. We report our experience to determine and illustrate a preferred method of MS. METHODS: Techniques for MS were selected based on the presence or absence of adequate dental stability and periodontal disease. All patients received general anesthesia with nasotracheal intubation before subluxation. Illustrations are provided to emphasize technical considerations in performing MS in 10 patients (nine men and one woman) who required MS as an adjunct to CEA (less than 1% of primary CEAs). Patients were symptomatic (n = 7) or asymptomatic (n = 3) and had high-grade stenoses demonstrated by means of preoperative arteriography. RESULTS: Subluxation was performed and stabilization was maintained by means of: Ivy loop/circumdental wiring of mandibular and maxillary bicuspids/cuspids (n = 7); Steinmann pins with wiring (n = 1); mandibular/maxillary arch bar wiring (n = 1); and superior circumdental to circummandibular wires (n = 1). MS was not associated with mandibular dislocation in any patient. No postoperative cranial nerve palsies were observed. Three patients experienced transient temporomandibular joint discomfort, which improved spontaneously within 2 weeks. CONCLUSION: Surgical exposure of the distal internal carotid artery is enhanced with MS and nasotracheal intubation. We recommend Ivy loop/circumdental wiring as the preferred method for MS. Alternative methods are used when poor dental health is observed.

Adult↗
PubMed1989

Cephalometric templates based on the Bolton standards.

An accurate, simple, rapid method of cephalometric profile analysis is proposed. Templates, derived photographically from the 9-year through 18-year male-female Bolton standard tracings, are used to define the optimal locations for any selected hard or soft tissue dentofacial landmarks. Discrepancies between the ideal and actual positions of each landmark are immediately apparent and graphically reveal existing deformities. No tracing or measurements are required, as the analysis is performed directly on the patient's cephalogram. The construction of the templates and their application to clinical cases are described.

Adolescent↗
PubMed1984

Crestal ostectomy and lateral wall compression for management of the enlarged pneumatized tuberosity.

The crestal ostectomy with lateral antral wall compression is a simple, predictable procedure to correct soft tissue and osseous hypertrophy in the pneumatized maxillary tuberosity. It offers certain advantages over other techniques: 1) simultaneous reduction of vertical and lateral aspects of the hyperplastic tuberosity; 2) simultaneous revision of hypertrophic or mobile mucosal tissue overlying the tuberosity; 3) avoidance of a horizontal scar band in the buccal vestibule, which may subsequently interfere with the denture flange; 4) negligible effect on the depth of the buccal vestibule; 5) fixation wires are not required; 6) rapid healing of the osteotomy site, since there is intimate bony contact; 7) expedient initiation of denture fabrication is possible because the palatal aspect of the tuberosity is not mobilized; and 8) no surgical stent is necessary.

Alveolectomy↗
PubMed1983

Complications associated with skin graft vestibuloplasty. Experiences with 100 cases.

The mandibular skin graft vestibuloplasty with lowering of the floor of the mouth is a relatively complex surgical procedure and can be accompanied by a large number of diverse complications. In our experience, these have ranged from minor inconveniences to a life-threatening emergency. Most could be easily prevented or simply managed. The complications encountered in a series of 100 consecutive skin graft vestibuloplasties are presented and discussed.

Airway Obstruction↗
PubMed1983

Instrument-marking tapes: an unnecessary hazard.

Instrument-marking tapes facilitate instrument preparation and packaging but can be responsible for increased surgical morbidity by fragmenting into the wound or harboring bacteria when old or damaged. Four cases of submandibular abscess formation and the potential failure of an oro-antral closure were directly attributed to the use of marking tapes.

Bacterial Infections↗
PubMedDate not supplied

Early diagnosis of asymptomatic oral and oropharyngeal squamous cancers.

An examination of the oral cavity and oropharynx in asymptomatic patients at high risk requires an orderly visual inspection of the entire oral and oropharyngeal mucosa with particular attention to the tongue, floor of mouth, soft palate, uvula, tonsillar pillars, and the lingual aspects of the retromolar trigones. Completion and clear documentation of the entire examination should be recorded. Detected lesions that do not resolve in a reasonable length of time--two to three weeks--require intense and assiduous investigation. The following specifics should be considered. 1. Alcohol drinkers and cigarette smokers, especially those 40 years of age and older, are at very high risk for the development of upper aerodigestive tract and lung squamous carcinomas. 2. The floor of the mouth, the ventrolateral tongue, and the soft palate complex are the high-risk sites within the oral cavity and oropharynx. 3. Persistent mucosal erythroplasia rather than leukoplakia is the earliest visual sign of oral and oropharyngeal carcinoma. These lesions should not be regarded merely as precancerous changes. The evidence indicates that these lesions in high-risk sites should be considered to be invasive carcinoma or carcinoma in situ unless proven otherwise by biopsy. 4. Toluidine blue staining is a useful diagnostic adjunct, particularly as a method of ruling out false-negative clinical impressions. It may also be used as a rinse in high-risk patients to encompass the entire oral mucosa after a negative clinical examination and as a guide to improve biopsy yields. 5. If oral or oropharyngeal cancer is identified, evaluations of the larynx, hypopharynx, esophagus, and lungs should be performed to rule out multiple primary cancers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗