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Biomedical subjects

F J Stucker

Publications and source records attributed to F J Stucker.

At least 19 recordsLinked to original sources
PubMed1992

An approach to management of keloids.

Keloids present a major therapeutic dilemma for the surgeon because of frequent recurrences. We use a new protocol for management of large primary or recalcitrant keloids. The technique employs carbon dioxide laser resection of the keloid and then allows the open wound bed to heal by secondary intention. The open wound is treated as though it were a third-degree skin burn. The wounds invariably orient their long axis parallel to the relaxed skin tension lines. No keloid has ever been noted to recur before epithelial migration is complete. Careful follow-up detects early recurrences that are then treated with injection consisting of 40 mg/mL of triamcinolone acetonide (Kenalog), 150 mg of hyaluronidase (Wydase), and 2% lidocaine via a dermajet. Thirty-seven patients were treated with this protocol and have been followed up for at least 2 years. A control rate of 84% has been achieved with compliant patients.

Adult↗
PubMed1992

The perichondrial cutaneous graft. A 12-year clinical experience.

The perichondrial cutaneous graft is a reliable and versatile composite graft that possesses unique properties for reconstructive surgery. The graft consists of epidermis, dermis, scant subcutaneous tissue, and the perichondrial layer. Our clinical experience completely mirrors our findings from animal studies. A clinical study of 112 perichondrial cutaneous grafts includes patients whose ages ranged from 7 days to 92 years. The various clinical applications for use of the perichondrial cutaneous graft include repair of auricular deficits, ectropion, certain facial defects, and a variety of nasal reconstructive situations. A review of our clinical experience demonstrates excellent cosmesis and no contraction of any of the graft. The graft is routinely harvested from the anterior conchal bowl, and the donor defect is closed after cartilage resection with a postauricular interpolated skin island ("flip-flop flap"). Numerous situations present many options for reconstructive surgery. The perichondrial cutaneous graft provides such an alternative, offering great reliability and superb cosmesis.

Adolescent↗
PubMed1991

Revision meatoplasty: management emphasizing de-epithelialized postauricular flaps.

Revision meatoplasty represents a unique reconstructive dilemma to the otolaryngologist. Often, the external canal and conchal skin are or have been involved in an inflammatory process and subsequent scarring that compromises or precludes its use in a reconstructive procedure. Our technique recommends one or more tongues of postauricular normal vascularized skin flaps be developed and rotated into the ear canal. The portion lying beneath the auricle is de-epithelialized as it is tunnelled under the conchal bowl. This random postauricular flap permits the introduction of healthy skin at the flap's tip for resurfacing the canal and meatus. Because the flap is introduced from a posterior direction, the inevitable scarring and forces of contraction serve to keep the meatus patent. This is marked contrast to usual repair attempts that introduce coverage at the meatus with a skin graft, which subsequently heals, with a circumferential scar compounding the stenosis. The exact design of the flap is generally determined by the presence or absence of previous postauricular healed scar. There is most often a previous postauricular incision from ear surgery that dictates the exact design of the flap or flaps. Superiorly and/or inferiorly based flaps have been used successfully. The segment that lies beneath the auricle is de-epithelialized using the CO2 laser. This greatly facilitates the speed and precision of the de-epithelializing maneuver. To date, 32 cases of conchal and external canal stenosis have been successfully managed using this technique. The indications, technical description, and representative examples are the basis of this manuscript, which offers the otolaryngologist a viable option in revision meatoplasty.

Adolescent↗
PubMed1990

Management of animal and human bites in the head and neck.

Management of bites requires both local wound and systemic considerations. The authors will highlight their experience in 32 cases. Interestingly in this series, human bites were more common than animal bites. The bacteriology, antimicrobial therapy, and surgical treatment of human and animal bites will be reviewed. A management protocol that we use is based on whether the bite was inflicted by a human, dog, or other animal. The discussion will include cases demonstrating immediate and delayed reconstruction. Long-term follow-up was possible for a number of these patients.

Adolescent↗
PubMed1988

Reduction cheiloplasty. An adjunctive procedure in the black rhinoplasty patient.

The reduction cheiloplasty is a simple surgical procedure that can easily be used adjunctively with a black patient who is undergoing rhinoplasty. Its acceptance by patients and surgeons is increasing, but his useful procedure continues to be underutilized. This article urges the incorporation of the reduction cheiloplasty in the armamentarium of those who routinely perform rhinoplasties on black patients. It is a relatively minor procedure that is easily reproducible and yields excellent, predictable results with few complications. The technique, pitfalls, and morbidity are outlined in this article. The improvement achieved in facial harmony by the addition of this procedure makes it a surgical bargain.

Black People↗
PubMed1988

Frontal sinus fractures: some problems and some solutions.

Head trauma can result in serious injuries leading to life-threatening situations. Often accompanying these injuries are fractures involving the frontal sinus. Some fractures are subtle and difficult to diagnose, while others are massive and difficult to treat. The experience at this institution in the management of frontal sinus fractures is examined. Particular emphasis is placed on the problematic cases. These include fractures that were nearly overlooked, those that were associated with massive CSF leaks, and those which were extensively comminuted. In treating some of the most severe compound injuries, a frontalis myofascial flap has been used successfully to "plug" the site of CSF leakage. The review will include the types of fractures encountered, associated injuries, errors in diagnosis, the treatment rendered, and the complications which resulted. As encountered in other studies relating to trauma, adequate follow-up has been a serious shortcoming. The protocol presently used in the management of these injuries will be outlined.

Adolescent↗
PubMed1987

Squamous cell carcinoma of the external ear: a review of 75 cases.

Squamous cell carcinoma of the external ear can be a potentially lethal lesion. Although it is the most common cancer involving the pinna, the variables that have the greatest impact on prognosis are still in question. We reviewed 75 cases of squamous cell carcinoma of the external ear to determine patterns of occurrence and treatment failure. Forty patients had adequate follow-up for determination of cancer control rates. Local control was successful with initial treatment in 85% of the cases. The incidence of lymph node metastases was 10%, whereas distant metastasis occurred in only one patient (2.5%). This series differs from others in that most patients were unselected and most of the lesions treated were early (less than 1 cm). The significance of positive margins after surgical excision is also analyzed.

Aged↗
PubMed1987

Non-caucasian rhinoplasty and adjunctive reduction cheiloplasty.

This article is based on 19 years of experience that includes more than 300 cases of reconstructive nasal surgery in non-Caucasians. The evolution of the author's surgical technique is presented, as influenced by long-term effects of various surgical maneuvers. The adjunctive reduction cheiloplasty is also discussed.

Black People↗
PubMed1979

Profile contouring including cheiloplasty.

Profile disharmony exists when there is an unattractive forehead-to-chin contour. An indication for correction arises when the appearance disturbs the patient. Often the patient believes rhinoplasty alone will improve the unpleasant profile. The surgeon must appreciate other deformitied and enlighten the patient of concurrent osseous and soft tissue abnormalities. Profile evaluation and treatment rarely requires complicated diagnostic and corrective measures. Complex mathematical evaluations followed by multistaged surgical procedures are impractical for most patients. My experience with augmentation of the nose and mentum with polyamide mesh in more than 200 cases indicates that it is a simple and safe material for implantation. Modification of the nasofrontal angle and cheiloplasty are minor adjunctive procedures and are readily combined with the basic rhinoplasty.

Chin↗
PubMed1979

The grand biopsy for the "cold" thyroid nodule.

A lobe and isthmusectomy is our standard surgical management for the cold nodule of the thyroid. Experience indicates that the great majority of cold nodules prove benign. It is manifest that the attendant morbidity for this surgery be extremely low. Our experience reviewing thyroid surgery for only benign disease indicates that complications are indeed uncommon. Our surgical management of the cold nodule includes resection of a lobe and isthmus with exploration and palpation of the opposite side. The nerve is routinely identified and preserved. In the past 18 months, we have experienced two minor postoperative complications in 36 consecutive cases of the lobe and isthmus resection for benign disease.

Biopsy↗
PubMed1978

A case against nasal packing.

Nasal packing is included in most technical descriptions of septal and rhinoplasty surgery with little accompanying discussion of its indications and possible pitfalls. We believe that routine nasal packing is not an innocuous step. There are certain specific indications for its use but these are uncommon. We suggest that exclusion of packing is a wiser alternative in routine procedures. Over 800 cases of nasal surgery have been reviewed with fewer than 9% requiring packing. The indications for such packing are described as are the alternatives. Problems and complications attendant with its routine use are explored.

Humans↗
PubMed1977

The lateral conchal resection otoplasty.

A procedure for surgical correction of protruding ears has been utilized in 118 cases. The technique incorporates steps to correct the most common deformities found on preoperative evaluation. The lateral conchal resection com bined with mattress sutures is not complex and thus readily learned by residents. It has yielded consistently excellent cosmetic results combined with an exceedingly low complication rate. The procedure is adaptable to well over 90 percent of patients seeking an otoplasty procedure.

Ear, External↗
PubMed1977

Use of implantation in facial deformities.

Augmentation of facial defects remains an area of challenge and controversy. Advocates of alloplastic implants cite the convenience of prepackaged materials, which they feel outweighs the possibility of rejection. Those favoring autografts prefer their long-term predictability, but must contend with resorption and the disadvantages of obtaining the implantation material. The use of supramid mesh may combine the advantages of allopasts with the long-term predictability of autografts after fibrous ingrowth has occurred. Our experience over the past 4 years in 164 cases indicates that supramide mesh may represent a significant advance in augmentation of facial deformities.

Amides↗