Biomedical subjects
Publications and source records attributed to H C Doku.
The first case of a rare and unusual solitary neurofibroma of the mandible that caused bony erosion and extension into the adjacent soft tissues of the infratemporal fossa is presented. The clinical, radiographic, and histopathologic features of the neurofibroma are reviewed. The diagnostic procedures and the surgical treatment of this tumor in a young child are discussed.
Administration of antimicrobial prophylaxis is advocated in procedures with a high risk of surgical wound infection. Recent advances in knowledge in this area include the broader recognition of risk factors that better predict the expected incidence of postoperative surgical wound infection than does the traditional wound classification system. In oral surgery, guidelines for antimicrobial prophylaxis based on established principles exist in the literature, and antimicrobial prophylaxis has been demonstrated to be effective in preventing postoperative surgical wound infection. However, surveys suggest that fundamental principles are often ignored, and antibiotics are often initiated at an inappropriate time and are continued beyond the time required to be influential on reduction of infection rates.
Intra-oral pyogenic granulomas have been associated with pregnancy. The exaggerated response of these tumors has been related to the hormonal changes occurring during this period. A change in the hormonal balance also occurs during puberty. In this paper, we present two young patients with large pyogenic granulomas and suggest that the hormonal changes play a primary role in the pathogenesis of this tumor.
A case of factor XI deficiency has been presented. The patient required 91 units of fresh frozen plasma for hemostasis, which is more vigorous therapy than was to be expected from reviewing the current literature.
Mock dentures were stabilized in six monkeys by means of polyethylene tubings passed through surgically created buccolingual peralveolar channels. Macroscopic, radiographic, and microscopic examinations demonstrated that the dentures were stabilized and the tubings well tolerated throughout the 120-day study period.
This report presents an unusual asymptomatic periapical radiolucency occurring around the upper right lateral incisor. Surgical intervention revealed an empty bone cavity which was diagnosed as a traumatic bone cyst. Follow-up periapical radiographs of the patient were taken over a 6-year period until complete healing of the lesion took place.
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An unusual case of mixed bacterial osteomyelitis has been reported. The prodominant organism, E corrodens, normally is an inhabitant of the aerodigestive tract; its pathogenicity should not be overlooked in the diagnosis and treatment of oral infections. In addition, descriptions of anemia of chronic disease and of the spontaneous healing of a large defect of the bone have been presented.
Dens in dente is the result of an invagination of the enamel organ into the developing dental papilla. The full pathologic potential of this lesion is often not fully appreciated. A case is reported in which a cyst resulting from a dens in dente obliterated the maxillary sinus and necessitated root canal therapy and apicoectomies in four adjacent teeth.
The similarities between the various conditions described are remarkable. The orbital or frontal bruit and pulsating exophthalmos are common only to the carotid-cavernous fistula. A recent history of dental treatment, of facial infection with an elevated white blood cell count, and leukocytosis suggests cavernous sinus thrombosis. The superior orbital fissure syndrome and orbital apex syndrome occur most frequently in conjuction with Le Fort II and III fractures, which can involve the optic foramen and superior orbital fissure, therefore disrupting the sensory and motor innervation to the orbit and adjacent structures (Fig 4). Direct orbital trauma without evidence of fracture and with all symptoms mentioned, except infection, bruit, and pulsating exophthalmos, suggests orbital hematoma. A thorough differential diagnosis with complete data is essential for a correct diagnosis, thereby reducing morbidity by institution of the appropriate treatment. Treatments for carotid cavernous fistula have varied over the years--all aiming toward abolition of the fistula. Currently, the preferred treatment is the supraclinoid clamping of the internal carotid artery, followed by muscle embolization of the internal carotid artery distal to the bifurcation, and clamping of the internal carotid artery in the neck.
Complicating infectious processes and manifestations of immunosuppression were either cured or symptoms were decreased with aggressive therapy in 24 patients with acute leukemia and five with chronic leukemia. Oral surgical intervention combined with histocompatability-matched transfusion therapy can safely eliminate sources of sepsis and alleviate pain in patients who have undergone immunosuppressive and myelosuppressive treatment.
Triamcinolone acetonide was injected into the mucobuccal fold adjacent to the surgical site where a vestibuloplasty with mucosal grafting had been performed. Macroscopically, the mucobuccal folds of the experimental group were both softer than those of the control animals and exhibited less tendency toward regression in the depth of the vestibule. Microscopic examination revealed qualitative rather than quantitative changes in collagen formation.
Intact and fenestrated full-thickness palatal mucosal grafts were placed following immediate vestibuloplasty in ten dogs of mixed breed. Macrscopic and microscopic findings indicated that the fenestrated grafts were as effective as the intact grafts in long-term maintenance of bestibular depth.
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The case of a patient with an extensive squamous-cell carcinoma of the floor of the mouth with erosion of the mandibular bone is presented. The history and initial clinical picture were consistent with either carcinoma with superimposed infection or chronic osteomyelitis with an acute exacerbation. A discussion of diagnosis and treatment of carcinoma of the floor of the mouth follows this case report.
A case of mandibular actinomycosis, secondary to a compound fracture in an alcoholic patient, is described. The factors that apparently enhance the development of this disease are discussed.
Vestibuloplasties with fenestrated palatal mucosal grafts were successful in eight patients. The fenestrated palatal mucosa provides a tough, full-thickness, resilient mucosal graft from a limited donor site. The operating time is decreased, bleeding is minimized, and healing time of the donor site is shortened. Fenestration allows seepage of blood and tissue fluids from beneath the graft. The fenestrated grafts are readily adaptable to any irregularities of the edentulous mandibular ridge.
The occurrence of thrombosis of the internal carotid artery is a rare entity. Such a case, in association with multiple facial fractures, has been presented. The management of the patient was complicated by neurological disturbances that affected definitive treatment. This case illustrates the importance of close monitoring of all patients with facial trauma before, during, and after surgery.