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Biomedical subjects

L R Boies

Publications and source records attributed to L R Boies.

18 recordsLinked to original sources
PubMed1987

Frontal sinus fractures. Analysis of treatment results.

A retrospective study of 112 consecutive patients with frontal sinus fractures who were available for follow-up is presented. Significant complications are possible, especially with fracture of the posterior sinus wall. When indicated, the sinus is reconstructed with wire using free denuded fragments if available. Severe complications in displaced posterior wall fractures were less common when treatment was by sinus obliteration than by cranialization. Computed tomography has improved the evaluation, especially when a posterior wall fracture is suspected.

Anti-Bacterial Agents↗
PubMed1983

Facial fractures in trauma victims: the influence of treatment delay on ultimate outcome.

To obtain objective data on the consequences of delayed treatment of facial fractures we reviewed the records of 220 patients who had suffered facial fractures concomitantly with extrafacial trauma severe enough in its own right to warrant hospital admission. Fractures studied were those of the mandible, maxilla, zygoma, and frontal sinus. Seventy-three patients fit inclusion criteria. Most injuries occurred in motor vehicle accidents. Associated extrafacial injuries were common and frequently multiple, the more serious of which generally took priority over the facial injuries in the triage system. The two most common reasons for delay were instability of the patient's neurological status, or initial non-recognition or poor definition of the facial fracture. Delays in treatment ranged from 0 to 24 days. In patients with mandible fracture only, delay of up to 24 days in definitive treatment led to no noticeable increase in morbidity due to malocclusion, infection, or nonunion. In no other facial fracture did treatment delay lead to an increased incidence of complications. Retrospective analysis of the patients who did suffer complications almost always revealed predisposing conditions that placed these patients at higher risk for poor results.

Adolescent↗
PubMed1982

Chronic osteomyelitis following mandibular fractures and its treatment.

In a review of 350 patients with mandibular fractures between 1976 and 1978, eight cases of chronic mandibular osteomyelitis were found. Treatment in all cases consisted of intravenous antibiotics and debridement. In addition, in some cases a suction-irrigation system was used after debridement. From this study, the following can be stated: (1) Osteomyelitis following mandibular fractures is uncommon. (2) Once chronic osteomyelitis has developed, aggressive antibiotic and surgical treatment is needed. (3) The use of the suction-irrigation system after debridement is an effective adjunctive aid in treating osteomyelitis. Cosmesis is superior to that obtained with older techniques because wounds are closed primarily.

Adult↗
PubMed1979

Delayed meningitis following stapes surgery.

Perilymphatic fistulae, developing even years after stapedectomy, open a communication between the perilymph and middle ear. These fistulae constitute a potential pathway for flora of the middle ear to invade the subarachnoid space by way of the cochlear aqueduct. Our patient developed pneumococcal meningitis 14 months after stapedectomy. The history of stapedectomy in a patient with meningitis is an indication for reexploration+ion of the operative site. The appearance of fistula symptoms in patients who have had stapedectomy indicates a high risk for development of intracranial infection.

Ear, Middle↗
PubMed1977

Stabilization of comminuted zygomatic fractures with external suspension apparatus.

An external fixation device using a suspension bar fashioned from dental compounds is described. The finished appliance resembles a drawer pull from which the fractured malar eminence is suspended. The apparatus is recommended for the treatment of comminuted, unstable zygomatic fractures where conventional means of stabilization have proved unsatisfactory or undesirable and where passive traction is desirable. Appliances fashioned from lightweight dental compounds offer the maxillofacial surgeon a safe, effective, and highly versatile means of stabilizing facial fractures.

Acrylic Resins↗
PubMed1976

Nonunion of the mandible.

Nonunion of the mandible was evaluated over a five-year period (1968-1973). Fourteen cases were noted out of 577 mandibular fractures for an incidence of 2.4 percent. Causes of the complications were determined by a careful review of the poorly healing and successfully treated cases of mandibular fracture. The most important feature in nonunion cases was the large proportion of edentulous patients. In these cases immobilization appeared difficult, especially when only one form of fixation was used to stabilize the fracture. Other suspected causes of nonunion were postoperative trauma and osteomyelitis. These factors were most prevalent in the lower socio-economic groups. Factors which did not appear important were sex, age and cause of the fracture. Analysis of the site of injury, combinations of sites, timing of treatment, periosteal stripping and general health of the patient failed to demonstrate any predisposition to the complication. Treatment of nonunion was confined to standard techniques of debridement, antibiotic therapy and further immobilization. Although most patients responded to this therapy, six patients required closure of the deficit by bone grafting. On the basis of accumulated data, it was possible to clarify the factors in the development of nonunion. It was also possible to recommend methods of prevention of the complication and to substantiate the success of several forms of therapy.

Adult↗
PubMed1976

The emergency management of trauma.

For effective care, the severely injured patient may require the cooperative effort of many physicians and paramedical personnel. In the individual with isolated maxillofacial injury, adequate management may be provided by one or several specialists. In any event, there should be a plan for emergency, semiurgent, and delayed treatment. It is also important for each individual caring for the patient to understand and appreciate the problems within and outside his area of expertise. There is a logical progression of evaluation, with particular attention to the more severe and significant area of trauma. Hemmorrhage, shock, and airway problems take priority. Often the definitive treatment, from a cosmetic and functional standpoint, is delayed.

Abdominal Injuries↗
PubMedDate not supplied

Venous hum as a cause of reversible factitious sensorineural hearing loss.

Self-heard venous hums have been previously documented and recognized as one cause of audible pulsatile tinnitus. A patient presented with a right internal jugular venous hum causing audible tinnitus and a right sensorineural hearing loss, both of which resolved after high ligation of the right internal jugular vein. We speculate that the hearing loss measured initially was factitious and represented a masking effect due to the venous hum.

Adult↗