Biomedical subjects

H E Hetherington

Publications and source records attributed to H E Hetherington.

4 recordsLinked to original sources

PubMed1996

Onlay bone augmentation with an osteoinductive implant.

The repair of contour defects of craniofacial bone can be accomplished by several methods, including autogenous bone grafts, demineralized bone, and alloplastic materials. The objective of this study was to assess a biodegradable, xenogeneic, osteoinductive implant for craniofacial onlay bone augmentation. Twelve New Zealand White rabbits each had craniofacial onlays consisting of three experimental materials: 1) autograft; 2) allogeneic, demineralized block implant; and 3) partially purified osteoinductive protein (osteogenin) with allogeneic collagen and 50:50 poly (DL-lactide-co-glycolide). Implants with host bone were recovered after 20 weeks and assessed by histomorphometric methods. There was no evidence of adverse local reaction to the three treatments. No significant difference in bone replacement or bone density resulting from each of the implant types was demonstrated. In conclusion, the osteoinductive implants were well tolerated, and over the 20-week period they appeared to maintain their contour as onlays.

Animals↗

PubMed1995

Bilateral maxillectomy and midfacial reconstruction.

Extensive bilateral midfacial defects including the upper jaw, palate, and sinuses present a formidable reconstructive challenge. Prosthetic restorations require a solid anchor point to be successful, since orofacial motion would otherwise cause instability of the prosthesis. We report on a series of eight patients who underwent transmalar placement of a Steinmann pin at the time of definitive tumor resection. The Steinmann pin was used immediately to securely anchor a prosthesis to the skull base. The maximum follow-up time is 9 years. The Steinmann pin has remained firmly anchored without significant loosening in six of these eight patients, and no major complications have resulted from its use. In conclusion, the transmalar Steinmann pin is an effective and immediate single-stage method of permanently retaining a midface prosthesis.

Adolescent↗

PubMed1995

Use of stainless steel implants in facial bone reconstruction.

Stainless steel has adequate strength, flexibility, ductility, and bio-compatibility for most maxillofacial implant applications. In addition, it is relatively cheap and easy to manufacture. Stainless steel may be effectively used in the maxillofacial region in the form of wires, pins, and plates. This article presents a technique for using a transmalar Steinmann pin to secure a midface prosthesis in cases of bilateral midfacial, bilateral maxillectomy, and total rhinectomy defects. The stainless steel pin may serve as a stable long-term anchoring if used for retention rather than load bearing. This method offers the potential for single-stage reconstruction and allows for prosthesis removal to inspect the surgical defect for early evidence of recurrence.

Face↗

PubMed1994

Jejunal graft reconstruction of pharyngoesophageal defects without microvascular anastomoses.

The purpose of this article is to describe transplantation of jejunal grafts without microvascular anastomoses for reconstruction of the pharynx and/or upper esophagus following oncologic resections. Even though use of free flaps including jejunum, a method that requires revascularization, continues to offer superior results in pharyngoesophageal reconstruction, the technique described in this article provides a readily available alternative. This timesaving technique is particularly useful if the surgeon encounters intraoperative complications related to either the microvascular anastomoses or to an unstable patient. The principal advantages of jejunal graft reconstruction include the absence of a need for microvascular anastomoses, a decreased operating time, a one-stage operation, and the replacement of pharyngoesophageal mucosa with like tissue. The disadvantages include the need for laparotomy, the requirement for a well-vascularized tissue bed, delayed wound healing, the need for stenting, and delayed initiation of oral intake.

Adult↗