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Biomedical subjects

J Raveh

Publications and source records attributed to J Raveh.

At least 37 records · Page 2Linked to original sources
PubMed1991

Treatment of 813 zygoma-lateral orbital complex fractures. New aspects.

A 10-year experience with surgical treatment of 813 zygomalateral orbital complex fractures is reviewed. Regardless of the type or severity of the fracture pattern, concomitant fractures of the orbital floor and rim were approached exclusively through the transconjunctival approach without a lateral canthotomy. The advantages of this approach compared with the subciliary access are the avoidance of a visible scar and markedly reduced incidence of postoperative lower eyelid complications such as ectropion and edema. Implants of lyophilized dura or cartilage and autogenous bone were used to reconstruct orbital floor defects. Malar asymmetry is a frequent complication of zygoma fractures resulting from inadequate three-dimensional reduction. Methods for accurate reduction and stabilization, indications for closed and open reduction, and management of the fractured infraorbital rim are emphasized. The indications for miniplates vs wire ligatures for the infraorbital rim are discussed. Long-term follow up and evaluation of the results with regard to the fracture pattern, complications, maxillary sinus dysfunction, and facial and orbital symmetry are presented.

Bone Plates↗
PubMed1990

[Primary optic nerve decompression in mid-face fractures].

In severe craniofacial-frontobasal injuries the optic nerve is quite often damaged. We report the findings and the visual outcome in 21 patients with severe mid-face fractures, who underwent primary optic nerve decompression after showing an afferent pupillary defect. During the subcranial exploration and the optic nerve decompression, fractures of the optic canal were found in 13 cases; a dislocated bone fragment could be removed in 6 patients. 9 eyes remained blind, but another 9 eyes regained good final visual acuity between 0.5 and 1.0. We conclude that fractures of the optic canal and dislocated bone fragments are often causes of optic nerve damage in mid-face injuries. The primary subcranial decompression of the optic nerve is a safe method to prevent secondary damage.

Adolescent↗
PubMed1990

Subcranial-supraorbital and temporal approach for tumor resection.

The advantages of the subcranial over the transcranial approach for fronto-orbital tumor resection and subcranial exposure of the skull base are described in this paper. The primary reconstruction and fixation of the bone grafts with miniplates or wire ligatures are illustrated. The utilization of lyophilized cartilage for the reconstruction of the orbital roof, as well as the bridging of the defects with Biocement, are pointed out. The reconstruction of the articulate fossa of the temporomandibular joint in extensive resections of tumors in the temporal area is emphasized.

Adult↗
PubMed1990

Subcranial approach for the correction of hypertelorism.

The subcranial approach for the osteotomy of the skull base and orbital roof in cases with hypertelorism is described. Advancement of the fronto-orbital segments is performed, avoiding the transfrontal procedure, thus making frontal lobe retraction unnecessary. The advantages of this method are pointed out.

Adult↗
PubMed1990

[The correction of craniofacial deformities].

Subject of this paper is to emphasize the advantages of our surgical procedure for the correction of craniofacial anomalies. Particularly for the fronto-orbital advancement in the hypertelorism and exophthalmus cases, this method enabled the reduction of the complication rate and the preservation of vital structures as well as a significant reduction of the morbidity rate. The advantages rendered by the bimaxillary osteotomy are discussed. The results and complications are evaluated.

Facial Bones↗
PubMed1990

[Mandibular reconstruction with the titanium-hollow screw-reconstruction plate system (THORP)].

The THORP system is designed for bridging mandibular defects and for internal osteosynthesis of mandibular fractures. The major aspects and advantages of the THORP system compared with the conventional reconstruction plates and screws are: 1. The rigid fixation of the head of the screw to the plate, thus avoiding unphysiological loads to the bone underneath the plate. 2. The titanium-plasma coated and perforated hollow screws enable the development of direct bone-titanium contact at the area of the thread as well as the ingrowth of bone into the lumen and perforations. Further advantages are the preservation of small fragments such as the condylar process with only two screws and the stable fixation of bone transplants. The specially designed freely adjustable condylar prosthesis guarantees a correct guidance and function of the lower jaw. The fixation of this system to the lingual aspect of the jaw is particularly significant avoiding decubitus and perforation of the skin in the chin area. The results and the complications of 141 reconstructions of the lower jaw are discussed.

Bone Plates↗
PubMed1989

Temporomandibular joint ankylosis: surgical treatment and long-term results.

The surgical treatment of 26 patients with ankylosis of the temporomandibular joint, as well as various methods and materials used for functional restoration are described. The significance of radical removal of the ankylotic bone, as well as the advantages of the interpositioning of the lyophilized cartilage, are emphasized.

Adolescent↗
PubMed1989

Open reduction of the dislocated, fractured condylar process: indications and surgical procedures.

The subject of this paper is the evaluation of the results after surgical management of 29 dislocated fractures of the condylar process. Only fractures with total dislocation of the condyle out of the articulate fossa were surgically treated. The surgical procedure, making a broad exposure necessary, is detailed. The low rate of complications as well as the satisfactory function of the joints in spite of severe dislocation seems to confirm the surgical treatment of this type of fractures.

Adolescent↗
PubMed1989

Mandibular reconstruction with the THORP condylar prosthesis after hemimandibulectomy.

The subject of this paper is the evaluation of the advantages pertaining to the THORP (titanium hollow screw reconstruction plate) condylar prosthesis for reconstruction after hemimandibulectomy and exarticulation. The THORP condylar prosthesis is three-dimensionally adjustable, enabling the intraoperative meticulous functional adaptation of the condyle. Various designs of the condyle make it possible to achieve optimal congruency between the articular fossa and condyle. The anchorage of the prosthesis to the stump of the mandible is achieved with perforated hollow-screws rigidly fixed to the plate, thus producing optimal functional stability. The long-term follow-up of eleven cases, reconstructed with this system, confirmed the correct guidance and functional efficiency of this type of condylar prosthesis.

Adolescent↗
PubMed1989

TMJ dysfunction: surgical management and reconstruction.

In this paper the surgical management of TMJ dysfunction-ankylosis and arthropathies-is described. The surgical techniques and the necessity of wide exposure are pointed out. Only thus are correct reshaping of the condyle, repair of the disc and radical resection of ankylotic bone tissue possible. The indication for prosthetic substitution to be interpositioned in cases with discal atrophy and perforation is discussed. There were no cases of facial paresis and no recurrence of ankylosis. The results, in regard to the functional aspects, confirm the efficiency of the methods described.

Ankylosis↗
PubMed1989

[Results following surgical treatment of post-traumatic temporomandibular joint ankylosis].

Trauma is the major cause for temporomandibular joint (TMJ) ankylosis. 20 patients with posttraumatic TMJ ankylosis were surgically treated with interposition of lyophilized homologous cartilage between the newly-formed condylar head and the articular fossa. The follow-up of all patients revealed a correct function of the TMJ. A meticulously performed surgical exposure is decisive for the prevention of facial nerve paresis.

Adolescent↗
PubMed1988

Subcranial management of 395 combined frontobasal-midface fractures.

In severe craniofacial injuries, the involvement of the skull base with concomitant major dural tears is significantly high. Our methods and treatment plan are controversial compared with the conventional procedure: primary urgent neurosurgical exploration and repair with deferral of maxillofacial reconstruction. To avoid the disadvantages of the transfrontal intracranial management of the skull base, we modified the transethmoidal approach so as to enable the subcranial exposure of all the anterior fossa planes, including the sellar-sphenoidal region. The advantages rendered by this method are the feasibility of an early one-stage craniofacial reconstruction and avoiding retraction of the frontal lobes and damage to the olfactory filaments. The reduction of pseudohypertelorism, the decompression of the optic nerve, and the meticulous reconstruction of the midface and skull base are performed in one session and are regarded as one entity. The results of the surgical management of 395 craniofacial injuries and the low rate of complications emphasize the advantages of the methods described in this article.

Facial Bones↗
PubMed1988

New techniques for reproduction of the condyle relation and reduction of complications after sagittal ramus split osteotomy of the mandible.

One hundred three patients underwent a modified sagittal ramus split osteotomy of the mandible. Maintenance of the temporomandibular joint relationship prior to the procedure was achieved postoperatively by using a three-dimensionally adaptable fixation bar. Techniques were also developed to avoid damage to the inferior alveolar nerve during the osteotomy and application of lag screws. These procedures avoided the disadvantages of lag screw osteosynthesis, and reduced relapse.

Bone Screws↗
PubMed1988

Reconstruction of the maxilla with bone grafts supported by the buccal fat pad.

In the usual reconstruction of maxillary contour, the grafts are usually exposed to the antral or nasal cavities. This leads to postponed remodelling and a higher rate of resorption and sequestration. To avoid exposure of the grafts, the buccal fat pad is rotated into the maxillary sinus and lined to the bone grafts. The vascularized buccal fat pad not only contributes to a better integration of the bone grafts but also enables the restoration of normal physiologic function of the maxillary sinus.

Adipose Tissue↗