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Biomedical subjects

M R Zenn

Publications and source records attributed to M R Zenn.

10 recordsLinked to original sources
PubMed2001

Introital stenosis requiring pelvic resection and soft tissue reconstruction.

BACKGROUND: Introital stenosis from both bony and soft tissue contracture is an unusual clinical problem not well addressed in the literature. CASE: A woman with a history of pelvic irradiation at age 1 for malignancy presented with severe introital stenosis unresponsive to conservative topical and dilatational therapy. She ultimately required staged bony resection of her infantile pelvis and soft tissue reconstruction to reestablish her introital aperture to an adequate and functional size. CONCLUSION: Introital stenosis from childhood requires a different treatment because development of the pelvis may not have been normal, and bony narrowing may exist in conjunction with soft tissue contracture. A staged multispecialty approach is recommended to treat this interesting variant of introital stenosis.

Adolescent↗
PubMed2001

Treatment of fibrous dysplasia of the mandible with radical excision and immediate reconstruction: case report.

Monostotic fibrous dysplasia of the mandible is an unusual manifestation of the disease that is usually benign, occurs in young individuals, and is managed by conservative curettage or debridement. We present a case of persistent fibrous dysplasia complicated by pain and intraoral bony exposure that was successfully managed by radical resection and reconstruction with a free fibular flap. Although mandibular fibrous dysplasia is preferentially managed conservatively, treatment of this disease has evolved to a point where total excision and immediate reconstruction may be the treatment of choice and offer the best outcome.

Adult↗
PubMed2000

Replantation of the penis: a patient report.

Replantation of the penis is an unusual case in this country and it is unlikely that most plastic and reconstructive surgeons or urologists will see one during their career. A successful repair of a self-inflicted amputation of the penis is presented. The unique anatomy of the penis pertinent to replantation is reviewed, and current concepts and recommendations in performing replantation of the penis are presented.

Adult↗
PubMed1997

Current role of the radial forearm free flap in mandibular reconstruction.

The radial forearm free flap was selected as a donor site in only 17 (11 percent) of 155 consecutive free flap mandible reconstructions performed over a 9-year period. It was used either as an osteocutaneous flap (58 percent), as a soft-tissue flap alone for coverage of a reconstruction plate (18 percent), to supplement another free flap (12 percent), or to salvage a previous reconstruction (12 percent). The most common underlying disease was epidermoid carcinoma (82 percent), the average patient age was 55 years, and the average length of follow-up was 13.5 months. Although there was one patient death, there were no anastomotic failures. Postoperatively, two patients experienced fracture at the donor site (12 percent), and three patients (18 percent) had hardware related problems such as exposure, infection, or both. Although early studies advocated using the osteocutaneous radial forearm flap as a preferred method in mandible reconstruction, superior donor site options such as the fibula have now relegated it to a minor role. The best remaining indication for its use today is for a limited posterior bone defect associated with a large adjacent mucosal loss. Osseointegrated implant capability is not important in this setting, and the short bone length needed for this application minimizes the potential for fracture at the donor site, a serious complication. Otherwise, the osteocutaneous radial forearm flap is not recommended for the majority of segmental mandibular defects. The radial forearm flap without bone continues to have an important supportive role in mandibular reconstruction. It is an excellent choice in this regard when used to cover a reconstruction plate, as a second free flap when soft-tissue requirements are exceptionally large, or for salvage of a previous mandible reconstruction.

Adult↗
PubMed1995

Subciliary malar augmentation and cheek advancement: a 6-year study in 22 patients undergoing blepharoplasty.

Twenty-two patients seeking aesthetic improvement of their eyelid and orbital-cheek region underwent malar augmentation and cheek advancement in conjunction with lower eyelid blepharoplasty by means of a subciliary incision. The follow-up ranged from 12 to 78 months, with a mean follow-up of 44 months. Concomitant other aesthetic procedures were performed in 27 percent of the patients. Satisfactory goals of lower eyelid aesthetic improvement and malar augmentation with cheek advancement were achieved in 21 of 22 patients. A single patient had her implants removed within 3 weeks of her initial operation, at her request. Complications included hematoma formation in two patients, transient ectropion in two patients, and a palpable implant edge in a single patient. There were no long-term functional or aesthetic sequelae. Malar augmentation and cheek advancement have been found to be a significant adjunct to lower eyelid blepharoplasty because they improve the appearance of the cheek region and add a youthful contour to the malar area. These straightforward procedures add an effective dimension to blepharoplasty in appropriately selected patients.

Adult↗
PubMed1993

Hypertrophic pyloric stenosis in the newborn.

Hypertrophic pyloric stenosis is exceedingly rare in newborns as well as patients over 6 months of age. These cases likely represent outliers from the normal distribution of its clinical presentation. This is a report of pyloric stenosis in a newborn. A review of the literature is included.

Female↗
PubMed1992

Variations in digital nerve anatomy.

One hundred digital nerves from 10 cadaver hands were dissected, and branching patterns were analyzed. Contrary to the traditional belief that the digital nerve predictably trifurcates at the distal interphalangeal crease, much variation exists. Terminal branching occurred distal to the crease in 60% of the thumb digital nerves and in 78% of the digital nerves supplying the other four digits. The number of terminal branches also varied from two to seven in the thumb and from two to five in the other four digits. No significant differences were seen in branching patterns between digits or between radial and ulnar sides. These findings are clinically relevant to the surgeon who is contemplating digital nerve repair.

Cadaver↗
PubMedDate not supplied

Microvascular reconstruction of the lower extremity.

Microvascular reconstruction has revolutionized the care of the lower extremity oncology patient. Radical limb-sparing surgeries may now be performed with the reconstructive option of unlimited transfer of tissues from elsewhere in the body. In its infancy, free tissue transfer provided vascularized tissue for wound closure. Experience with microsurgery and creative thinking have now combined to address limb function and aesthetics. In oncologic surgery, limb salvage of a functional lower extremity is currently the rule, not the exception. Semin. Surg. Oncol. 19:272-281, 2000.

Humans↗
PubMedDate not supplied

Helical advancement with a posterior auricular pull-through flap: A technique for reconstruction of combined helical and scaphal defects.

Ear reconstruction after skin cancer resection has traditionally challenged the reconstructive surgeon and many techniques of reconstruction have been published as a testament to this. With the widespread use of Moh's technique for resection, more tissues are now available after resection, and this has created a new challenge for the reconstructive surgeon-to use creatively all the remaining tissues and maximize the aesthetics of the ear reconstruction. This paper demonstrates a one-stage technique for reconstruction of a combined helical and scaphal Moh's defect which utilizes helical advancement with a posterior auricular skin flap.

Aged↗