[Local hemostasis in the maxillofacial region with aid of fibrin adhesive system].
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Biomedical subjects
Publications and source records attributed to F Wepner.
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A device for the prevention of intraoral soft tissue injuries in comatose patients with uncoordinated chewing movements is presented. Shape and material of the device, which is easily fashioned and handled, are designed to protect oral and buaccal soft tissue structures against self inflicted injuries.
Modifying and extending Bernard's method Fries (1971) developed a universal technique for reconstructive surgery of the lip after tumour resection. So far this technique has been employed in 80 cases, 50 of which were available for follow-up studies. Cosmetic results were invariably found to be optimal. Functional deficits were predominantly associated with whistling and pouting, while eating, speaking and laughing were unimpaired.
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Using adequate number of cases, the influence of the spread of primary tumour and the degree of regional metastasis on prognosis were investigated. Assuming a practicable classification as a prerequisite for clinico-therapeutic cancer research, experience has shown that the assessment of the spread of primary tumour alone does not suffice for the establishment of comparable homogenous data. The investigation on the importance of the degree of regional metastasis has shown, above all, that the percentage of N3-metastasis within the T-groups contributes essentially to the fact that these show a marked difference in their prognosis. It would therefore appear necessary also to examine the importance of other clinically accessible data in the assessment of prognosis. Only then could we be in a position to judge whether, and to what extent a clinically practicable classification and integration into special groups is possible on the basis of clinically available data. The inclusion of more clinics in the joint investigation is encouraged.
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Problems associated with the classification of cavum oris and labial carcinomata were discussed with particular reference to patients admitted to and treated in seven different clinical hospitals where identical methods of diagnosis and case history evaluation had been used. Using electronic data processing and biostatistical methods it was possible to study the effects of two clinically detectable factors (growth of primary tumor and degree of regional metastasizing) on both the prognosis and classification according to UICC rules. It was possible to show that a determination of the size of primary tumor (T) alone was not sufficient for three homogeneous, prognostically different collectives of tumors to be satisfactorily classified by the new UICC rules. It has been shown that a classification of three collectives of tumors (new classification according to UICC rules), especially as regards the proportion of N3 metastases within the collectives of tumors, was made possible. Therefore, it will be necessary to study the prognostic influences of additional clinically determinable factors with a view to arriving at a useful and practicable classification of oral cavity carcinomata.
An attempt is made to analyse mid-face deformities objectively in operated cleft lip and palate patients with the help of cephalometric techniques. Mid-face growth of cleft patients after the age of 10 years is compared with growth parameters of non-cleft subjects. This comparison indicates that some of the angles in the nasal area (Subnasale angle, Alaria angle) do not undergo any change in size with increasing age. Others which are subject to change (Rhinion angle, Pronasale angle) show no difference in the extent of growth between cleft patients and normal subjects inspite of different conditions at the age of 10 years. The lateral growth of the nasal soft parts (bialar distance) is largely independent of the lateral growth of the bony structures.
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