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Biomedical subjects

M R Klingensmith

Publications and source records attributed to M R Klingensmith.

5 recordsLinked to original sources
PubMed1995

The chondrocutaneous helical rim advancement flap of Antia and Buch.

BACKGROUND: The cutaneous surgeon commonly encounters defects of the helix, as 2-4% of all skin cancers occur at this site. OBJECTIVE: We report our experience with 47 patients using the chondrocutaneous helical rim advancement flap of Antia and Buch. METHODS: Incisions are made from the defect inferiorly into the lobule and, when necessary, superiorly along the helical sulcus into the helical crus. The postauricular skin is extensively undermined to allow maximal movement of the resulting broadbased, well-vascularized flap(s). RESULTS: We experienced very favorable results using this technique with our patients. No necrosis due to ischemia occurred in any of our cases. Hematomas formed postoperatively in two patients, but healing proceeded uneventfully after removal of coagulated blood. CONCLUSION: This technique is an excellent method of repairing many defects of the helical rim. Its advantages include technical simplicity, little risk of tip necrosis, patient convenience, and superior cosmesis.

Ear Cartilage↗
PubMed1985

A comparison of retention and complication rates of large-bore (Paparella II) and small-bore middle ear ventilating tubes.

Large-bore myringotomy tubes are usually reserved for the treatment of refractory middle ear effusion. Theoretically, they have an extended intubation time and a higher complication rate. There is, however, scant support of this in the literature. The duration of intubation, efficacy, and complication rates of the large-bore Paparella type II tube were compared with Paparella type I, Shepard, and Armstrong tubes. The study included 242 patients with 600 intubations. In addition, a subpopulation of patients receiving their initial intubation during this study was reviewed. Findings were similar for both groups. Paparella type II tubes had a prolonged period of intubation and a decreased reintubation rate when compared with the smaller bore tubes. Larger bore tubes had an increased complication rate when compared with the smaller bore tubes. Complications included occasional or frequent otorrhea and an increased rate of permanent perforation of the tympanic membrane. There was no instance of cholesteatoma formation secondary to intubation. Guidelines are presented for the use of the Paparella type II tube.

Adolescent↗
PubMedDate not supplied

The tooth as a foreign body in soft tissue after head and neck trauma.

Thorough evaluation of dentition is important in the management of craniofacial trauma. Avulsed or fractured teeth in the pulmonary and gastrointestinal tracts can lead to serious complications that are well described. However, the penetration of avulsed teeth into soft tissues of the head and neck is unusual and may not be recognized. Two cases in which a tooth became a foreign body in these soft tissues are illustrative. One patient had bronchoscopy for possible aspiration of an avulsed maxillary canine; it was later found embedded in the premaxillary tissues. The other patient had a right mandibular molar propelled into the posterior triangle of the left side of the neck. Physicians must be aware of dental injury resulting from facial trauma and account for all teeth as part of their evaluation, keeping an open mind as to where a missing tooth might be located.

Accidents, Traffic↗
PubMedDate not supplied

Analysis of methods for nasal tip reconstruction.

BACKGROUND: Numerous traditional and contemporary methods for nasal reconstruction are used today. Our investigation qualitatively analyzed different methods of nasal tip reconstruction which led to the development of an algorithm for repair based on the size, depth, and location of tissue loss. METHODS: A case series of 165 nasal tip reconstructions performed during a 2-year period followed for at least 6 months was critically analyzed with photographic documentation. RESULTS: Different methods of reconstruction exhibited varying aesthetic results. Analysis of surgical reconstructions led to the development of an algorithm based on the area of tissue defect. CONCLUSIONS: An algorithm was developed for nasal tip reconstructions based on the size and location of tissue defect. Both the recipient and donor sites were analyzed for aesthetic result and complications.

Algorithms↗