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Biomedical subjects

H Reychler

Publications and source records attributed to H Reychler.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Prosthetic dental rehabilitation on osseointegrated implants placed in irradiated mandibular bone. Apropos of 50 implants in 17 patients treated over a period of 5 years].

The authors report on their experience with prosthetic dental rehabilitation of 17 patients after surgery and radiotherapy for oncologic diseases of the oral cavity. 50 implants were inserted either in the mandibular residual bone or in a bone graft. These implants were inserted at least 5 months after radiotherapy, and functionally loaded at least 5 months after implanting. Depending on the degree of edentation, 2 to 6 implants were necessary to allow for a functional removable or fixed denture. 2 implants were lost because of lack of osseointegration and 10 were lost because of death of 4 patients. The longest observation period was 56 months and the mean observation time was 29 months. Not any osteoradionecrosis occurred : nevertheless, implantation in irradiated bone must remain a carefully planned operation in selected patients with a rigourous therapeutic protocol.

Adult↗
PubMed1996

Chronic diffuse sclerosing osteomyelitis of the mandible or mandibular location of S.A.P.H.O. syndrome.

The chronic diffuse sclerosing osteomyelitis (CDSO) of the mandible has been described as an inflammatory disease characterized by recurrent episodes of intense pain in the mandible, often accompanied by trismus, paresthesia and progressive mandibular deformity. The etiopathogeny of this entity is not fully known. The differential diagnosis must be carried out very carefully, and the treatment results are very disappointing. Recently, evidence that suggests that CDSO may be the mandibular location of a more diffuse condition, the synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome, has been offered. We describe two clinical cases of CDSO of typical evolution which fulfill the criteria for SAPHO syndrome, offering us an occasion for a review of the current literature.

Acne Vulgaris↗
PubMed1995

[Craniostenosis and craniofacial dysmorphia].

The paper gives a brief historical survey of craniostenosis and the first operative approaches. The authors describe a classification of various types of cranio-facio-stenosis and facio-cranio-stenosis and present a detailed study of their experience in this area. Operative results are discussed in function of the selected surgical procedure, the immediate per- and post-operative complications and the short and long term morbidity. The authors present their current attitude for each dysmorphic type. They underline the heavy nature of this long-lasting and bleeding surgical procedure that concerns small children. They have recorded 31 incidents in relation with surgical procedure, 10 complications at short and long term, and 1 death. Such surgery requires an experienced and vigilant team, associating surgeons, anesthetists and intensive-care physicians.

Child, Preschool↗
PubMed1995

[The role of microsurgery in the reconstruction of loss of substance of soft tissue in the maxillofacial region].

Reconstruction of oncological defects in the maxillofacial region still remains a real surgical challenge due to the complexity and the tridimensional aspect of these defects responsible for heavy functional impairment. Microsurgery allowing the transfer of free flaps gives the surgeon the opportunity to adapt a specific reconstruction to each defect and to reinsert the patient in a quasi normal social life. These reconstruction technics are routinely used in many centers; they must be integrated in our therapeutic arsenal and in the training of the maxillofacial surgeon. Seven years ago, we incorporated microsurgical reconstruction in our therapeutical concepts and today, it seems to us important to share our experience of microsurgical reconstruction in the field of soft tissues defects in the maxillofacial region.

Facial Neoplasms↗
PubMed1995

Ketorolac tromethamine for postoperative analgesia in oral surgery.

Sixty patients were randomly allocated to receive placebo or i.v. ketorolac tromethamine 30 mg during the induction of anaesthesia for dental removal. Pain score (VAS), mouth opening and oedema were evaluated. Pain intensity was assessed by the patient using a visual analog scale 1, 2, 6 and 24 hrs after surgery. Mouth opening and oedema were evaluated at the same times by an observer not implicated in the study. In ketorolac group, pain relief was better at each considered time (VAS: p < 0.001). Oedema was also significantly lesser. There was no difference in mouth opening. No side effect was observed. These data suggest that ketorolac reduces post-oral surgery pain and oedema.

Adolescent↗
PubMed1995

[Microsurgical reconstruction of the mandible].

The authors present two clinical cases of mandibular reconstruction using free vascularized bone grafts and dental osseointegrated implants. A wide discussion about the different techniques of reconstruction is reported. Several factors like the clinical history, age, general conditions of patient's health can influence the choices of the surgeon. The characteristics of the different donor sites are described, so the advantages and disadvantages of the different free microvascular flaps are analyzed. According to the authors not only the technical aspects of microsurgery but also a good choice of the right free flap plays an important role in a successful result. The influence of radiotherapy on microvascular reconstruction in the head and neck region is also discussed. The authors recommend the use of fibula and scapula as donor site for reconstruction of complex (i.e. interesting also the adjacent soft tissues, muscles, mucosa and skin) mandibular defects that require more than 6 cm of bone graft length. Corticotomies of bone ensure a perfect adaptation of the graft to the mandibular form with a good aesthetic result, while the use of dental osseointegrated implants allows total masticatory functional rehabilitation. It's important that these techniques must be utilized in well organized hospital centers by experienced surgeons who are able to resolve entirely the problems and needs of the patient.

Alveolar Process↗
PubMed1995

[Treatment of fractures of the mandibular condyle].

The current treatment of mandibular condyle fractures still remains unclear. The choice between surgical and conservative treatment is difficult in current clinical practice. Every possible treatments are here presented to give the oral and maxillofacial surgeon a better knowledge about what to do in presence of a mandibular condyle fracture.

Adolescent↗
PubMed1995

[The role of autologous parietal bone graft in alveolar cleft].

Autologous bone grafting of alveolar clefts is a well recognized procedure. Calvarium represents an interesting donor site because of the absence of morbidity and the dimensional stability of this membranous bone compared with endochondral bone sources. The authors reponed their experiences with this type of grafting used in 17 patients. Referred to the parameters analized in an important Swedish study, the rate of success was about 80% agree with the results of other authors with the same type of graft. Aspects of general planning, timing, technique and failure are extensively discussed. Pre and post surgical orthodontic treatment is also very important for a good result. The pattern of maxillo-facial growth and the effect of the graft materials on facial development are mentioned. The study of literature indicates that the best grafting results are achieved when free autogenous mandibular symphyseal bone grafts were used. The only true disadvantage is the small quantity of bone tissue available. The authors conclude suggesting the use of chin bone grafting in situations where the technique provides sufficient bone and recommend the use of cranial vault as the alternative source of membranous bone graft, for example, in bilateral clefts, when anterior theeth are not erupted yet and in any other situation where the mandibular bone graft is not possible.

Adolescent↗
PubMed1995

[Free antebrachial flap with radial pedicle. I. Theoretic considerations and indications in maxillofacial reconstruction].

The authors detail the anatomical, physiological, and clinical considerations of the free forearm flap. These characteristics determine the many indications of this flap in the maxillofacial surgical reconstruction. Contraindications are quasi inexistent. The second part of this work analyses the surgical and microsurgical operative technique use for the authors. All different parts of this work are discussed upon a deep review of the recent literature.

Facial Muscles↗
PubMed1995

[Antebrachial free flap with radial pedicle. II. Surgical technique].

The authors detail the anatomical, physiological, and clinical considerations of the free forearm flap. These characteristics determine the many indications of this flap in the maxillofacial surgical reconstruction. Contraindications are quasi inexistent. The second part of this work analyse the surgical and microsurgical operative technique use for the authors. All different parts of this work are discussed upon a deep review of the recent literature.

Facial Muscles↗
PubMed1994

Mandibular reconstruction with the free fibula osteocutaneous flap.

Experience with 17 mandibular reconstructions by the free fibula flap is presented. The main advantages of this reconstruction method include the bicortical structure of the bone and its adaptability to conform to the mandibular contour. The only real disadvantage is the limited height of the bone graft, which does not allow alveolar ridge reconstruction. An implant-borne dental prosthesis can, however, generally be made for functional occlusal rehabilitation.

Adult↗
PubMed1994

[Treatment of oral epidermoid carcinoma].

This review analyses systematically all therapeutical known features about oral cancer. Every therapeutic modality involving surgery, radiotherapy and chemotherapy is detailed and an exhaustive literature review about each therapy concept is made.

Aged↗
PubMed1994

[Dry socket. Prevention and treatment].

Although dry socket is a frequent and painful affection, its pathogenesis is still unknown. We present here a review of the literature to propose a logical preventive and therapeutic attitude. The clinical and histological aspects are also tackled.

Dry Socket↗
PubMed1993

[Orbito-fronto-temporal approach to tumors at the base of the skull. Our experience in the creation of orbito-zygomatic-malar flap].

The authors describe the technique of mobilization of the osseous orbito-zygomatico-malar complex pedicled to the masseter muscle. In some affections it is justiciable to use this approach which provides an excellent view of the lateral region of the medial cranial fossa and orbit and permits the access to the base of the tumor by a intra- and extracranial approach without traumatic injury for the brain and easy reconstruction.

Adult↗