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Biomedical subjects

K K H Gundlach

Publications and source records attributed to K K H Gundlach.

11 recordsLinked to original sources
PubMed2006

[Neonatal cervical teratoma: case report].

Cervical teratomas are extremely rare tumours. Surgery of these mostly benign malformations is very challenging for a multidisciplinary team. A single case of a newborn, who was imminently prenatally diagnosed with a neck mass, is presented. After delivery the patient was transferred to neonatal intensive care unit and intubation was performed. A rapid growth of the mass required early surgery and removal of the neck mass was performed on the third day post delivery. Histological investigation showed an immature teratoma. The postoperative period was complicated by hypothyroidism. Due to severe laryngo-tracheomalacia tracheostomy was required when the baby was 2 weeks old. Further development has been without any sign of recurrence (12 months). On the basis of this case differential diagnosis, therapy and outcome is discussed.

Cesarean Section↗
PubMed2003

[Facial clefts and their coding with LAHS nomenclature].

Research and treatment of clefts of lip, alveolus, and palate requires exact, reliable and reproducible terminology and documentation. In this paper we suggest a simple system to record a detailed diagnosis for every case of cleft. All anatomical regions involved by the cleft are considered and the extent in these regions is described. This nomenclature has been proposed for usage by the Interdisciplinary Cleft Palate and Craniofacial Anomalies Committee of the German Associations for Cranio-Maxillofacial Surgery, Orthodontics, Phoniatrics, Pedaudiology and ENT.

Cleft Lip↗
PubMed2003

[Development, standardisation and evaluation of a model for arthroscopic surgery of the joint. An experimental study in pigs].

AIM OF THE STUDY: The aim of this study was to establish a reliable educational model for and a further refinement of arthroscopic surgery in the temporomandibular joint (TMJ). MATERIAL AND METHODS: As a first step, the lateral-medial (length) and anterior-posterior distances (width) of the mandibular head of nine pig cadavers (country breed) of about 30 ( n=3), 60 ( n=3) and 90 kg ( n=3) body weight were measured and compared with findings in 12 adult human cadavers. The best points of access for the arthroscopic and lavage channels using the triangulation technique were determined. As determined by these findings, 15 arthroscopies were performed on eight pig TMJs under general anaesthetic. A control arthroscopy was performed after 2 weeks followed by another clinical follow-up at 4 weeks before the pigs were sacrificed. RESULTS: The TMJ of the pigs between 30 and 60 kg body weight was found to be highly comparable to the human TMJ. The best locations for puncturing the upper joint compartment of the TMJ in pigs were 5.0 cm and 6.1 cm anterior to the tragus on a line drawn along the lower margin of the zygoma. The only complication encountered was a subcutaneous infection treated successfully by antibiotics and incision. CONCLUSIONS: In our opinion, a standard and easily reproducible model is necessary for further studies in arthroscopic TMJ-surgery. The country bred pig represents a good model for educational purposes and for studying further refinements of arthroscopic technique.

Adult↗
PubMed2003

[Treatment of congenital clinical anophthalmos with high hydrophilic hydrogel expanders].

INTRODUCTION: Children presenting with congenital anophthalmos usually develop a smaller bony orbit, a constricted mucosal socket, and a shortened eyelid fissure. This causes problems when fitting these patients with a prosthesis. Clinical evaluation of the Wiese self-inflating hydrogel expanders has demonstrated their ability to expand the socket and eyelid fissure for inserting a more realistic prosthesis in shorter periods of time. PATIENTS AND METHOD: The study included 13 consecutive anophthalmic patients, eight unilateral and five bilateral. Each patient received a hemispherical osmotic tissue expander in the rudimentary mucosal socket and later a sphere implanted in the deeper soft orbital tissue. RESULTS: The use of hydrogel expanders enlarged the lid and palpebral fissure in all children, with good cosmetic results. It allowed insertion of custom-made glass prostheses with good cosmetic appearance very early in life. Growth of the bony orbit may be stimulated successfully by these expanders in the soft orbital tissue. CONCLUSIONS: The enlargement of constricted mucosal sockets and short palpebral fissures using self-inflating hydrogel expanders is a new and successful concept in treating congenital anophthalmos.

Anophthalmos↗
PubMed2003

[Congenital clinical anophthalmia and blind microphthalmia].

Congenital anophthalmia and blind microphthalmia are very rare conditions and there is no standard treatment available. Various previously reported therapeutical concepts are reviewed. The clinical picture can be divided into three subgroups with different therapeutical options recommended: in microphthalmia the conjunctival sac size is usually normal or slightly decreased. The use of non-expandable conformers is possible with good results. Patients treated with hydrogel expanders can wear a prosthesis earlier and with better cosmetic results. In congenital anophthalmia the conjunctival sac is very small and contracted and patients cannot wear a prosthesis or even a conformer. Hydrogel expander treatment--first for the conjunctival sac and second for the orbit--is the therapeutical option which may lead to good cosmetic results. Children >5 years of age and/or unsuccessful pre-treated cases may benefit from osteotomy to reduce mid-face asymmetry. To attain the main therapeutical goal in this subgroup, the ability to fit a normal prosthesis, a combination of different techniques like hydrogel expanders, dermis fat graft, lid surgery etc. may be necessary.

Anophthalmos↗
PubMed2003

Malignant conversion of florid oral and labial papillomatosis during topical immunotherapy with imiquimod.

We report a case of a 61-year-old woman suffering from florid oral papillomatosis with a squamous-cell cancer of the floor of the mouth, which was removed by scalpel surgery combined with a radical neck dissection in 1996. Between 1996 and 2000 several histologically benign papillomatous lesions of mouth and lips were removed with laser and electrosurgery. However, the lesions recurred. In July 2000 hyperkeratotic, wart-like lesions were present at the lower and upper lips and at the right angle of the mouth and the adjacent oral mucosa. Overnight treatment with a topical 5% imiquimod cream on a Monday-Wednesday-Friday schedule was initiated. However, due to severe irritation and pain the application had to be reduced to 4 h per night, three times a week, followed by a therapy-free interval of 2 weeks. Despite this treatment consisting of four cycles of 3 weeks (1 week treatment and 2 weeks pause), the lesions increased markedly in size. A biopsy taken from the tumorous lesion from the right angle of the mouth proved to be a squamous-cell carcinoma. The tumors of the labial and oral mucosal sites as well as the right submandibular lymph nodes were removed by wide scalpel excision. The lips were reconstructed by plastic surgery. 24 months after surgical intervention no recurrence nor metastasis to lymph nodes or distal sites were observed.

Aminoquinolines↗
PubMed2002

[Stimulating regeneration of bone defects by implantation of bioceramics and autologous osteoblast transplantation].

QUESTION: Does artificial stimulation of osteoconduction and osteogenesis lead to improved bone formation in defects of critical size? MATERIAL AND METHODS: Full-thickness, critical-sized defects in the anterior mandible were created in 24 adult mini-pigs. These defects were treated with a new kind of bioactive ceramic (60% hydroxylapatite and 40% beta-tricalcium phosphate), applied as a unique sol gel [9]. The bioceramic was tested alone and in combination with autologous osteoblasts. In a control group, periosteum was the only bone-producing source. After 5 weeks, the animals were sacrificed and the defects analyzed clinically, histologically, and by X-ray examination. The effects of periosteum, bioceramics, and osteoblasts were investigated in particular. RESULTS: The new bioceramic was degraded at the same speed as new bone was laid down. The rate of newly formed bone was highest in the bioceramic group at 72.3% (control group with periosteal covering only 59.3%). Additional transplantation of autologous osteoblasts did not result in faster bone production. CONCLUSION: It seems that this bioactive ceramic is successful as a bone replacement material and will be suitable as a carrier for osteoinductive substances such as bone morphogenetic proteins.

Animals↗
PubMed2002

[Millard gingivoperiosteoplasty. An alternative to osteoplasty of alveolar clefts].

PURPOSE: The gingivoperiosteoplasty according to Millard is a possible alternative treatment modality to osteoplasty; no second operation for harvesting the bone graft is necessary. The goal of this investigation was the comparison of gingivoperiosteoplasty with osteoplasty and a search for factors that led to an improvement of the prognosis of both techniques. MATERIAL AND METHODS: Long-term results of 53 patients with 72 alveolar clefts who underwent gingivoperiosteoplasty and 74 patients with 103 clefts of the alveolus were analyzed radiographically following an osteoplasty at the age of 12-14 years. The amount of bone in the alveolar cleft was determined and related to a number of factors such as number of teeth, unilateral or bilateral cleft, and orthodontic treatment. The statistical analysis was done with the Mann-Whitney U-test (p < 0.05). RESULTS: The rate of success was similar following gingivoperiosteoplasty and osteoplasty with a range of 68% to 73%. A postsurgical orthodontic expansion of the alveolus and the existence of lateral incisors improved the prognosis for both techniques significantly (p < 0.05). Teeth erupted into the new periosteally formed bone. This was observed in 82% of those patients in whom enough bone was formed. CONCLUSION: The gingivoperiosteoplasty according to Millard is a real alternative to a common osteoplasty at the age of 12-years if a lateral incisor is found at both cleft margins and if postsurgical orthodontic expansion of the upper jaw is performed.

Adolescent↗
PubMed2002

[Primary "swallowing" function in relation to cleft type after 18 years of interdisciplinary therapy].

PURPOSE: The aim of today's interdisciplinary treatment of clefts is complete aesthetic and functional rehabilitation of the patient. But is it possible to also achieve a physiological swallowing pattern? MATERIAL AND METHODS: At the Rostock cleft center patients are treated by an interdisciplinary approach from their day of birth until their 18th year of life. Tongue position during swallowing was investigated in 117 consecutive patients. They were assigned to four groups. The control group consisted of 197 age-matched patients receiving non-cleft orthodontic treatment. RESULTS: Patients with clefts of only the primary or only the secondary palate achieved physiological swallowing in 87% or 88% of cases at the age of 18. Of the unilateral CLP cases, 74% also had a physiological swallowing pattern, but in patients with bilateral complete clefts this pattern could be observed in only 46%. In comparison, 95% of non-cleft patients achieved a physiological swallowing pattern following orthodontic and speech treatment at the age of 18. The so-called anterior swallowing pattern was the pathological pattern found most often in cleft and non-cleft patients. CONCLUSION: In most cleft patients interdisciplinary treatment leads to a physiological swallowing pattern. Only patients with bilateral clefts of lip and palate have a critical prognosis. They need special care and attention.

Adolescent↗
PubMed2002

Traumatic myositis ossificans (ossifying pseudotumor) of temporal muscle.

The purpose of this paper is to present the clinical, radiographic, and histological aspects of a case of traumatic myositis ossificans of the temporal muscle. This is a rare, benign ossifying pseudotumor of skeletal muscles. It had developed 3 weeks after trauma to the left temple in a 33-year-old man. Differential diagnostic aspects of traumatic myositis ossificans confirming its benign character are discussed.

Adult↗