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Biomedical subjects

J M Vaandrager

Publications and source records attributed to J M Vaandrager.

At least 19 recordsLinked to original sources
PubMed1995

Dehiscence of the jugular bulb in Crouzon's disease.

Patients with Crouzon's disease have a distorted nasopharynx, which frequently leads to retained middle ear secretions and necessitates myringotomy. A review of the computed tomographic (CT) scans of 21 ears in 11 patients with Crouzon's disease found that 12 jugular bulbs were protruding or dehiscent. The relationship between the jugular bulb and the middle ear space was normal bilaterally in only 2 of the 11 patients. Consequently, patients with Crouzon's disease are at risk for inadvertent puncture of the jugular bulb during myringotomy. CT scans obtained prior to myringotomy can be helpful in detecting dehiscent or protruding jugular bulbs.

Adolescent↗
PubMed1994

Clinical evaluation of techniques used in the surgical treatment of progressive hemifacial atrophy.

We critically review 13 patients with progressive hemifacial atrophy treated with three basic surgical procedures (free flap transplantation, alloplastic implants, micro-fat injections 'lipofilling') and further ancillary techniques. In spite of the satisfactory results achieved with the procedures, with the exception of alloplasts, we feel that lipofilling may be considered an interesting solution for soft tissue augmentation of the face especially for moderate adipose defects, due to its repeatability, no donor site morbidity, no complications at the recipient site such as lesions resulting from dissection, bleeding, necrosis, etc. This technique can be performed in a day-hospital with short surgery time, at low cost and without a highly skilled team. For severe grades of adipose atrophy, because of the low blood supply to these tissues which interferes with take of any type of autograft, we think that free flaps actually represent one of the best solutions for soft tissue augmentation.

Adipose Tissue↗
PubMed1994

Progressive hemifacial atrophy in a patient with lupus erythematosus.

This is a single case report describing a young woman with progressive facial atrophy that began at age 15. After she underwent commissuroplasty and collagen injection at age 29, her symptoms continued to progress, and she was ultimately shown to have serologic evidence of systemic lupus. She had a "remission of symptoms" after commencement of medical treatment (chloroquine and topical steroids) for her lupus. The association of progressive hemifacial atrophy and lupus is not new. This case and other cases associated with different autoimmune diseases suggest an autoimmune collagen-vascular origin for some cases of progressive facial atrophy. Furthermore, there is a need to modify the surgical approach in light of concurrent disease.

Adult↗
PubMed1994

[Scaphocephaly. Its clinical study and surgical treatment].

The authors report a clinical study in 51 patients with scaphocephaly. Since 1986 the mathematical patterns of projection geometry have been applied to the reshaping of the skull in the early surgical correction of scaphocephaly. The mathematical and geometric principles are discussed and the surgical technique utilized is illustrated. Results are presented. The authors, encouraged by the very satisfactory results obtained, suggested the application of the method for the reshaping of the skull in other craniofacial malformations.

Craniosynostoses↗
PubMed1993

Reshaping of the skull in the early surgical correction of scaphocephaly.

It is possible to modify the mathematical patterns of projection geometry to reshape the skull in cranio-facial surgery. The technique of the 'gore-pattern' in accordance with the Hendel procedure changes the shape of individual sections of the skull by changing their radius of curvature. This technique was well known to engineers who built complex structures such as ships, hulls, airfoils and domes. A rigid form of the desired shape is the result to be achieved, which becomes permanent with healing. The gore-pattern is developed by cutting the surface of the sphere along longitudinal lines. Straightening each piece results in a series of elliptical segments referred to as 'gores'. When constructing a sphere from a flat sheet of material, each segment (gore) is bent through 180 degrees and then assembled side-by-side into a sphere. If the gore is cut in the middle, a hemisphere results. Because there are only small areas of contact between the gores, less bending force is necessary to fold a gore-pattern into a sphere than a zone-pattern. The interesting points of this technique, its advantages, and clinical application in the treatment of skull deformity in scaphocephaly are illustrated.

Biophysical Phenomena↗
PubMed1993

[Scaphocephaly: mathematical and geometrical principles. Surgical incidences].

Authors have reported the mathematical and geometrical principles of cranioplasty used for the surgical treatment of patients with scaphocephaly. After a review of classical mathematical procedures utilized to modify the surface of spherical or hemispherical structures, and after some considerations about relevant properties of bone, the authors illustrate the possibility of a clinical application. The technique described and used in a series of 40 patients, is a simple adaptation of the principles used by engineers to build complex structure such as ships hulls, domes and airfoils. The very satisfactory results obtained, encouraged us to extend the application of the method reports to the reshaping of the skull in other cranio-facial malformations characterized by abnormal skull morphology.

Craniosynostoses↗
PubMed1991

[Good results with the surgical treatment of trigger finger (tendovaginitis stenosans)].

Stenosing tendovaginitis (trigger finger) may be treated surgically or conservatively. Surgical incision of the proximal part of the flexor tendon sheath in 100 patients (91 adults and 9 children) proved a reliable method. In 97 patients the resistance was abolished by surgical treatment, with good functional results. It is a simple procedure, with hardly any complications and a short follow-up period.

Adult↗
PubMed1990

Implantation of porous acrylic cement in soft tissues: an animal and human biopsy histological study.

Long-term (8 and 24 month) reactions of the (hypo) dermis of the guinea pig to solid and porous (50 vol%) acrylic implants and four human biopsies from porous subcutaneous acrylic implants were studied light microscopically. The solid implants were encapsulated by dense connective tissue. Mobility was evidenced by the loss of 4 out of 36 after 2 yr and was considered the explanation for the occurrence of ectopic cartilage and mineralized material at some solid implants' surfaces after 2 yr. A dense capsule was not evident with the porous implants, instead vascularized collagenous connective tissues penetrated into and filled the pores, thus anchoring the implant to the body. None of these implants, was lost. Notwithstanding the presence of some multinucleated giant cells, scattered inflammatory cells and loosely packed inflammatory foci with both implant materials, the materials were considered well-tolerated by the body. The histology of the human biopsy did not differ significantly from the porous animal implants.

Acrylic Resins↗
PubMed1988

Porous acrylic cement: evaluation of a novel implant material.

The preparation and some properties of in situ curing porous acrylic cement, a modification of the traditional bone cement, are described. Through numerous animal experiments, the behavior of the porous cement in a biological environment has been studied. The histological evaluation reveals that hard and soft tissues readily grow into the pores of the cement, thus anchoring the implant to the host tissues. Some inflammatory foci, decreasing in number with residence time, together with varying numbers of multinucleated giant cells were found occasionally in the tissues in and around implants. When implanted in soft tissues, the porous cement behaved favorably with respect to solid acrylic implants because of the immobility of the implants and the absence of ectopic hard tissue formation. The biocompatibility of porous acrylic cement is judged to justify clinical trials in plastic and reconstructive surgery.

Animals↗
PubMed1988

Craniofacial contouring and porous acrylic cement.

Porous acrylic cement permitting ingrowth of soft and hard tissue was developed in the mid-1970s. After several years of animal experimentation, a clinical trial started in 1978. Twenty-nine selected patients had craniofacial contouring with in situ curing porous acrylic cement. It is an easy one-stage procedure with a good fixation of the prosthesis. The result is a definite good contour reconstruction. It offers the craniofacial surgeon a useful alternative in selected cases when autogenous bone grafting or an intracranial approach is not indicated or not sought by the patient.

Carboxymethylcellulose Sodium↗
PubMed1988

The radial forearm flap.

The radial forearm flap or 'Chinese' flap, originally used as a fasciocutaneous flap based on the radial artery, is extremely versatile and can be employed as free vascularized or island flap with or without skin, vascularized nerve, tendons or bone. The radial forearm flap was performed in 21 patients (16 free and 5 as a distally based island flap) for head and neck as well as for hand and foot reconstruction. All flaps survived. Indications and complications are discussed.

Adolescent↗
PubMed1987

[Craniofacial surgery].

A craniofacial team is functioning since 15 years in Sophia's Children Hospital and Dijkzigt Hospital. An intensive-care unit and a anaesthesist specialised in children is imperative for proper functioning of the team. An overview of the most common Craniofacial malformation is given, the operative technique of craniosynostosis described and the complications discussed.

Cleft Lip↗
PubMed1984

The use of a temporal osteoperiosteal flap for the reconstruction of malar hypoplasia in Treacher Collins syndrome.

The clinical use of a temporal periosteal bone flap for the reconstruction of a malar bone in a patient with the Treacher Collins syndrome is presented. The temporal muscle functions as an axial carrier of the periosteum that induces osteogenesis in young children, whereas the bone segments may serve as a nucleus for further bone formation from the periosteum. Correction of the eyelid coloboma was obtained by the rotation and advancement of a temporopalpebral flap.

Bone Transplantation↗
PubMed1983

Surgery related to the correction of hypertelorism.

The importance of skeletal reduction of the interorbital distance in the treatment of patients with teleorbitism is now well recognized. In spite of this, results of surgery are not always as good as one would hope. For this there are two reasons: (1) reduction of the interorbital distance may be followed by deformities such as canthal drift, enophthalmus, pseudoptosis, and so forth; and (2) hypertelorism is frequently associated with a variety of other malformations that become more conspicuous after reduction of the interorbital distance. In this paper attention is focused on the mechanisms responsible for the appearance of new stigmata, on their prevention, and also on the treatment of the associated malformations.

Abnormalities, Multiple↗
PubMed1982

Pathology and treatment of nasoschizis.

A craniofacial malformation is caused by a developmental arrest that results in focal fetal dysplasia. The severity, location, and number of these dysplasias make a wide spectrum of abnormalities possible. In this spectrum nasal dysplasia and, more particularly, the malformations characterized by a cleft in the lateral part of the nose play a prominent role, but in past years they have received only scant attention. In Tessier's classification this nasoschizis is the Number 1 cleft. We present here our observation in 2 patients with nasoschizis and the procedure used to correct it. Both patients were operated on at the Rambam Medical Center in Haifa, Israel.

Cleft Lip↗