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Biomedical subjects

F Carls

Publications and source records attributed to F Carls.

6 recordsLinked to original sources
PubMed2002

Classification of oral clefts by affection site and laterality: a genotype-phenotype correlation study.

OBJECTIVES: The aim of this study was to classify the phenotypes found in a series of patients with non-syndromic cleft lip (CL) with or without cleft palate (CP) and isolated cleft palate. Additionally, the frequency distribution of cases belonging to families linked to markers on chromosomes 6 and 2 within these phenotypic patterns were estimated. DESIGN: A retrospective examination of all the available affected cases collected in Italy. SETTING AND SAMPLE POPULATION: Ninety-seven affected subjects aged 5-18 years belonging to 38 families were considered. Patterns were identified by variance of the cleft (lip, primary palate, secondary palate) and stratified according to the side of occurrence (right, left, or bilateral). Latent class analysis was used as main statistical tool for carrying out the results. RESULTS: Three homogenous classes were identified (P < 0.0001) by means of latent class analysis. Individuals were assigned to the most suited class. All three variables (lip, primary and secondary cleft palate) generated a specific class. Optimal findings were reported in cases having 'any isolated cleft lip' (class 1); 'secondary CP with or without bilateral/right primary cleft palate + bilateral/right cleft lip' (class 2); and 'left primary cleft palate + left/bilateral cleft lip with or without secondary CP' (class 3). Correspondence to the evidence of linkage to chromosome 6 showed that 9 of 10 cases presenting with 'right primary CP + right CL with secondary cleft palate' (class 2) belonged to a linked family. The same combination, but occurring on the left side (class 3), revealed that only three of nine cases belong to families linked to chromosome 6 (P-value = 0.02). The two patterns (right and left) never occurred in the same family. Three reliable groups were identified based on laterality and the presence of a cleft. A single right sided pattern displayed a statistically different distribution of linkage to chromosome 6 when compared with the homologous left side. CONCLUSION: Non-syndromic CL with/without CP can be classified according to laterality that can be under genetic control.

Adolescent↗
PubMed1997

[A method for true nose lengthening].

There are various methods of lengthening the nose after trauma or for congenitally short noses. Forehead flaps and bone and cartilage grafts to the nasal dorsum are routinely performed. Bone grafts to the dorsum are onlay grafts that can show resorption. In craniofacial procedures, e.g., after Le Fort II/III osteotomies, the nose is brought forward and downward as necessary. This principle for nasal lengthening has been applied to 11 patients with congenitally short noses or after trauma. A coronal incision was made, an extensive subperiosteal skin undermining above the entire nasal bones and the piriform aperture was performed. Then a naso-frontal osteotomy was carried out, which runs downward to the piriform aperture. It runs either anteriorly to the lacrimal sac or it runs behind it through the medial orbital wall. It then crosses the inferior orbital rim and runs from there into the nasal floor. The nasal lining is released and the osteotomized fragment mobilized and moved caudally and anteriorly. This results in a deviation of the nasal septum, requiring a septoplasty. Cranial bone grafts (outer table) are interposed in the osteotomy gaps and fixed with microplates. This method of nose lengthening was applied to 11 patients with good results.

Adult↗
PubMed1996

CT assessment of orbital volume in late post-traumatic enophthalmos.

The potential of CT to facilitate preoperative planning of reconstructive maxillofacial surgery by orbital volume quantification was analysed in 11 patients with traumatic enophthalmos as a late sequela of zygomatic fractures. We carried out biplanar CT examination of the orbits, and calculated total orbital and fat volumes for the healthy and enophthalmic sides. Displacement of the orbital floor and lateral wall was present in 11 and 7 cases respectively. Indentation of the medial wall was noted in 9 cases. Quantitative evaluation of the orbital cavity revealed a significant increase (P < 0.0188) in total volume on the enophthalmic side, the difference between the two sides ranging from 9.2% to 36.4%, mean 17.9%. The degree of enophthalmos, measured radiologically as 2.5-5 mm, correlated with the increase in orbital cavity volume (P = 0.000076). Enophthalmos was 2.5-3 mm in 7 cases (63.6%) and 3.5-5 mm in 4 (36.4%). This corresponded with a mean increase in orbital volume of 3.4 ml (12.3%) and 7.1 ml (27.8%) respectively. Fat atrophy was not an aetiological factor in the production of post-traumatic enophthalmos.

Adult↗
PubMed1996

Assessment and treatment of facial deformity resulting from radiation to the orbital area in childhood.

Children who receive radiation for malignant tumors in the orbital area frequently develop widespread craniofacial deformities. These affect the skull, orbit, maxilla, and mandible. When these patients seek treatment at a later age, they require careful assessment using cephalometrics and three-dimensional imaging. It is recommended that the four levels of skeletal deformity be corrected in a single procedure, that is frontotemporal expansion with repositioning of the skull base area, orbital expansion and repositioning together with maxillary and mandibular surgery. Bone grafts should be inlay rather than onlay and soft tissue should be supplied by free-tissue transfer. This counteracts any residual ischemia related to the previous radiation therapy. The second surgical stage is designed to reconstruct the socket and the eyelids to allow more satisfactory rehabilitation with an ocular prosthesis. In patients who have a globe present, the usual enophthalmos can be corrected by repositioning of the eye as part of the first procedure by reducing the anteroposterior dimensions of the socket. In bilateral cases, the deformity is hourglass in nature and requires correction in the frontal and temporal area with lateral displacement of the orbits. A bimaxillary procedure is also indicated. It is emphasized that to formulate a satisfactory operative plan an in-depth three-dimensional analysis of the deformity is mandatory.

Child↗
PubMed1987

[Painful pronation--a diagnostic pitfall in septic arthritis and osteomyelitis of the elbow in infancy].

Pulled elbow is a common injury in infancy and childhood. The history and clinical findings are usually classical, but one should never forget that the classical history can always be easily reconstructed by the examining physician. It can be estimated that in 93% of all cases a dramatic response to therapy can be observed. In the remaining 7% the most common cause for failure to treatment is an incomplete or recurrent subluxation of the radial head and distortions or fractures of the elbow. But in approx. 1% the examining physician must suspect a hidden osteomyelitis or osteoarthritis of the elbow. With adequate antibiotic therapy the prognosis is generally good. To avoid this diagnostic pitfall, it is essential to re-examine carefully all cases which do not respond to therapy in order to exclude an osteomyelitis.

Arthritis, Infectious↗