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Biomedical subjects

K G van der Wal

Publications and source records attributed to K G van der Wal.

At least 19 recordsLinked to original sources
PubMed2001

Surgical treatment of Graves orbitopathy: a modified balanced technique.

Surgery has a definite place in the treatment of the exophthalmos in Graves orbitopathy. Thirty-two patients with Graves orbitopathy were operated on. Twenty patients received a three-wall orbital decompression. Five patients received a two-wall orbital decompression with lipectomy and seven patients underwent a two-wall orbital decompression combined with an advancement osteotomy of the supra-, lateral- and infra-orbital rim and a lipectomy. In cases with Hertel values less than 25 mm, the two-wall orbital decompression with removal of orbital fat. and in cases with Hertel values more than 25 mm, the two-wall orbital decompression with lipectomy and an advancement osteostomy of the supra-, lateral- and infraorbital rim is the treatment of choice.

Adolescent↗
PubMed2001

Facial reconstruction on the abnormal skull model of a living patient.

OBJECTIVE: The concept of using a skull as the armature upon which to reconstruct a face has been understood for many years. The objective of this study was to blindly test this technique by using a skull that was reconstructed from the computed tomography (CT) scans of a living 48-year-old man. DESIGN: The patient had a bilateral cleft lip, alveolus, and palate. A model of the complete skull produced by a computer-controlled milling machine that used data from the CT scans was used for the reconstruction. Surgery was then performed, and new dental prostheses were also constructed. After surgery, a second model of the relevant part of the skull was made and the reconstruction modified accordingly. CONCLUSION: Despite having no information about the patient apart from that which could be gleaned from the model skull, the reconstructions demonstrate the approximate appearance of the face before and after surgery. Even without the extra information routinely available in forensic cases, a face broadly similar to that of the living patient could be achieved.

Anatomy, Artistic↗
PubMed2000

Intraorbital bamboo foreign body in a chronic stage: case report.

A case of intra-orbital bamboo foreign body in a chronic stage is presented. This case seems to confirm the importance of radiological examination, including three-dimensional computed tomography to choose the optimal surgical approach to remove the foreign body.

Adolescent↗
PubMed1998

[Skating fun and fractures of the maxillofacial bones].

Skating is a favourite sport in the Netherlands. Injury data on skating were collected from the emergency departments of 6 hospitals in the province of Friesland in the Netherlands during the Eleven Cities ice skating marathon over 200 kilometers in January 1997, with 16,688 participants. Among a total of 55 fractures, the maxillofacial skeleton had a relative high fracture frequency (n = 7; 13%), especially the zygomatic complex (n = 6); one patient had a mandibular fracture. An innocent-looking black eye, unilateral numbness of the upper lip and malocclusion following a skating accident merit full medical attention.

Adult↗
PubMed1997

Bone grafting the piriform aperture deformity in isolated cleft lip patients: indication, technique, and results.

PURPOSE: This study was undertaken to determine the effect of a bone graft in the piriform aperture on the nasal deformity and orthodontic treatment of the cleft side teeth in isolated cleft lip patients. PATIENTS AND METHODS: All primary cleft lip repair was done 3 months after birth. Nine patients, four female and five male, with a mean age of 12.5 years (range, 8.2 to 24.8 years) and with a repaired cleft lip, were bone grafted between 1992 and 1996. The mean postoperative period was 2 years (range, 1 to 4 years). An iliac crest bone graft was placed in the piriform aperture deformity on the side of the cleft lip. The improvement in the nasal symmetry and angulation of the cleft side teeth were evaluated. The eight growing cleft lip patients (mean age, 11 years; range, 9 to 13 years) were compared with a control group of eight healthy growing children (mean age, 11 years; range, 9 to 13 years). The improvement of nasal symmetry was measured by the formula of the lobule portion of the columella index preoperatively and postoperatively. RESULTS: The mean lobule portion of the columella index preoperatively was 41.8% (SD, 4.4%; SE of Mean, 1.5%) and postoperatively was 44.2% (SD, 4.9%; SE of Mean, 1.6%) (P > .006, t-test for paired samples). The angulation of the cleft side teeth was improved by orthodontic treatment. CONCLUSION: Bone grafting the piriform aperture deformity results in a stable result and improves nasal symmetry and the angulation of the cleft side teeth.

Adolescent↗
PubMed1997

The jaw index: new guide defining micrognathia in newborns.

OBJECTIVE: Newborns with glossoptosis due to micrognathia can suffer from life-threatening respiratory distress and severe feeding difficulties. These characteristic features are found in newborns with Pierre Robin sequence. In the relevant literature, no concensus concerning diagnosis for these children can be found. A guide defining micrognathia can be helpful in the diagnosis of glossoptosis and possible airway obstruction. METHOD: The jaw index is obtained in newborns by measuring three facial dimensions. In a series of 100 healthy neonates the standard measures were defined. RESULTS: The average jaw index in children with Pierre Robin sequence differs significantly from the reference group and was found to be over 3.6 times the normal value. CONCLUSIONS: Micrognathia can be defined with the jaw index.

Airway Obstruction↗
PubMed1995

Surgical treatment of proptosis bulbi by three-wall orbital decompression.

PURPOSE: Three-wall orbital decompression was tested using a coronal approach as a technique. PATIENTS AND METHODS: Three-wall orbital decompression by a coronal approach was performed in three patients with proptosis due to Grave's ophthalmopathy, in six patients with Grave's ophthalmopathy because their vision was threatened due to optic nerve compression, and in one patient with exorbitism due to Crouzon's syndrome for cosmetic rehabilitation. RESULTS: Proptosis reduction averaged 4.7 mm. The technique provides good access to the orbital walls, facilitating adequate proptosis reduction, and leaves no visible scar. Diplopia, present preoperatively in four patients, was improved in three patients and unchanged in one. There was no loss of visual acuity.

Adolescent↗
PubMed1993

Median cleft lip without holoprosencephaly. Case report.

A patient with median cleft lip is reported, but the patient showed no evidence of holoprosencephaly, which was ruled out by MRI. When the neonate's head circumference is within two standard deviations of the mean and normotelorism occurs with median cleft lip, it can be assumed that the brain is not holoprosencephalic. The importance of this cannot be overemphasized because median cleft lip is commonly associated with holoprosencephaly and severe microcephaly. The mother developed overt diabetes mellitus after the patient was born. However, infants of diabetic mothers are known to be at increased risk of giving birth to infants with holoprosencephaly. Since a prediabetic woman may sometimes give birth to large and/or malformed infants before developing overt diabetes mellitus, it is intriguing to speculate that the prediabetic state might have resulted in a forme fruste of holoprosencephaly, affecting, in this case, only the face and not the brain.

Anodontia↗
PubMed1993

Squamous cell carcinoma arising in a residual cyst. A case report.

A case of squamous cell carcinoma (SCC) arising in a mandibular residual cyst in a 62-year-old man is presented. The treatment included enucleation followed by primary closure. Histologic examination revealed a poorly differentiated SCC in the cyst lining without invasion through the connective tissue wall. Eight and a half years later, the patient was still free from recurrence.

Aged↗
PubMed1991

Traumatic luxation of the eyeball.

Traumatic injuries of the orbit may lead to luxation of the eyeball. This complication is of uncommon occurrence. Aetiology, clinical features, prognosis and treatment are discussed on the basis of the occurrence of the luxation of the eyeball in a 30-year-old man.

Adult↗