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Biomedical subjects

M Stricker

Publications and source records attributed to M Stricker.

At least 19 recordsLinked to original sources
PubMed1992

[The first- and second-arch syndrome. A treatment analysis and plan].

There is a very great lesion staging in these syndromes, and a great number of procedures have been described, according to the age and severity of the lesions. The initial assessment is therefore important, since it allows classifying these malformations according to their severity in key sectors. Scheduling the treatment in time must take account of: growth, the necessity to perform successive operations in one region, since no operation must hinder a subsequent one. It is essential to determine the optimum time for bone reconstruction. An early treatment with a conventional bone graft, without any intrinsic growth potential, condemns the reconstructed region to immobility, therefore to a progressive degradation of the result in time and to successive corrections. Early reconstruction is justified only if the available reconstruction means allow the reconstructed area to grow, either naturally or with the aid of orthopaedic stimulation. Some means seem to be available to date. A choice must therefore be made between: delayed morphological surgery, early functional surgery. Considering the extent of the means implemented, this is reserved for severe cases. The other great problem is the reconstruction of the auricle, which most often requires a series of operations scheduled over 2 years. The middle ear may not be operated if the lesions are unilateral. The other malformations, including macrostomia, muscular and neural abnormalities, involvement of the eyelids, sometimes require correction, which must fit in a repair schedule that must be established as soon as possible and must take account of the predictable procedures in order to prevent them from hindering each other.

Abnormalities, Multiple↗
PubMed1991

Postaxial acrofacial dysostosis (Miller) syndrome: a new case.

We describe a new case of postaxial acrofacial dysostosis (Miller) syndrome. This syndrome consists of mandibulofacial dysostosis, similar to that seen in Treacher Collins syndrome, and postaxial limb deficiency. The mode of inheritance remains uncertain.

Abnormalities, Multiple↗
PubMed1990

[Role of micro-anastomosed muscular transplantation in corrective surgery of permanent facial paralysis].

Vascularized and reinnervated transfer of a muscle from the body to the face is never a simple procedure. It is important to evaluate the pre-operative state of facial muscles. It is difficult to define the correct indications for the various surgical techniques proposed: muscle selection, selection of recipient vessels, selection of a reinnervation method, the positioning of the transferred muscle. The authors present a series of 12 cases of long standing facial paralysis for more than 3 years. Results are presented. The authors think that the ideal muscular transfer is still unknown. In principle, nothing can replace facial muscles except facial muscles. Currently, the authors prefer the latissimus dorsi flap with partial transfer. For reinnervation, the facial nerve must take the priority, while all other reinnervation technics should take second place. In all cases, great attention must be paid to the positioning of the muscle, the usefulness of conventional palliative procedures and the continuous moral support to all of these patients.

Facial Paralysis↗
PubMed1990

[Entropion: therapeutic indications].

The severity of entropion depends on trichiasis which is perpetuated by orbicularis spasm, creating a vicious cycle. The therapeutic approaches are based on the aetiopathogenesis. Congenital entropion is essentially treated by infraciliary cutaneomuscular resection. The various components of involutional (senile) entropion, horizontal and vertical retraction, orbicularis dyskinesia, are treated respectively by tissue reduction, reinforcement of retractore and myoplasties. In cicatricial entropion, chondro-mucosal or fibromuscular graft is the technique of choice for correcting insufficiency of the tarsoconjunctival plane or its curvature. It is also the best solution for the correction of trichiasis or distichiasis.

Burns, Chemical↗
PubMed1990

[A complete intermediate temporomandibular joint prosthesis. Evaluation after 6 years].

Since 1983 we have inserted more than 100 temporomandibular joint prostheses. A review after 6 years allows the respective indications to be listed and the complications to be studied in 72 insertions involving 62 cases suitable for analysis. The prosthesis is a total intermediary prosthesis forming an unsealed cupula composed of 2 halves--a mandibular portion and a temporal portion. Insertion of the prosthesis requires preliminary facial nerve dissection then osteotomy of the mandibular condyle and its subsequent drilling to allow the screwing in of the prosthesis. The prosthesis was used in traumatology, in condylar and high sub-condylar fractures, in the event of failure of functional treatment, in malformation syndromes, in tumors and, finally, in degenerative pathology. 13 prostheses were removed. A study of the probable causes of complications shows a predominance of technical problems related to inaccurate positioning of the prosthesis, in that it was not placed in the axis of the condyle, or that inadequate bicortical support was present. In our opinion, these complications do not question the conception of the prosthesis but rather indicate that it is necessary to perfect the insertion technique while taking advantage of improvements in the prosthesis which are currently under study.

Ankylosis↗
PubMed1990

[Repair of mutilations of the lacrimal apparatus].

Repair of mutilated lacrimal passages should be adapted to the anatomy and physiology. Whenever possible, this should be performed as an emergent operation and come in as part of an overall therapeutic strategy. Repair methods used are simple end-to-end approximation of permeable segments, in case of limited lesions, and use of arterial grafts or of adjacent, nasal or saccular mucous flaps, in case of extended lesions. When reconstruction is not feasible owing to the extent of the lesions or to failure of the repair methods, tear derivation is carried out directly via the lacrimal sac or nasal fossa, by means of intermediate flaps (primarily nasal mucosa) or indwelling drains. Objectively, the functional outcome of repair is hard to assess, as tearing can, by no means, be considered a clinical criterion of obstruction, in the same way as lack of tearing is not a criterion of permeability. Only dacryography or, when possible, postoperative scintigraphy of the lacrimal passages allow for an objective evaluation of the results. Thus, although satisfactory results are the rule, long-term objective observation often leads to mitigating feelings.

Dacryocystorhinostomy↗
PubMed1990

[Reconstruction of the temporomandibular joint and its alternatives].

Reconstruction of the temporomandibular joint is always quite problematic. --Use of a prosthesis. Many prostheses have been propounded to deal with the operational problems. As, in our opinion, these seem not to meet the usual orthopaedic surgery requirements, we developed a totally intermediate prosthesis with non-sealed cupula. The use of this prosthesis, whenever feasible, provides the solution for the problems with which we have to contend during reconstruction surgery in traumatology and degenerative or tumoral disease. Nonetheless, its use remains limited to adults. --Utilization of biological material: following numerous attempts made with the conventional osteocartilagenous grafts (metatarsal, rib), we believe that the proper orientation, walking in Chang's footsteps, is toward the use of the head of the second metatarsal bone as a microanastomotic transfer. It seems to us that this technique must be used in children, particularly those with malformation syndromes or ankylosis.

Bone Transplantation↗
PubMed1989

[Posterior cranial dysmorphy. Classification and an original technic of correction: parieto-occipital transposition].

The posterior part of the skull, frequently overlooked, is altered directly and indirectly in numerous pathological situations. Lesions of the cranial contents, alteration of the lambdoid suture, abnormal constraints related to posture or to muscular activity modify the posterior curvature of the skull, generally in the form of flattening. Examination of the posterior part of the skull is essential in the context of neurosurgery and craniofacial malformations. The dysmorphy can be corrected by an original, personal technique of biparieto-occipital transposition restoring a harmonious curvature allowing immediate weight-bearing.

Brain↗
PubMed1989

[Computerized tomography in the diagnosis of craniomandibular disorders: radiological-surgical comparison].

Among 500 C.T. scan of temporomandibular joint (T.M.J.), examined since 1982 by bilateral direct sagittal method (Department of Radiology, Pr. A. TREHEUX, C.H.U. Nancy-Brabois), the authors have retained 14 cases of patients with symptoms related to dysfunction of the T.M.J. cured by surgery (Department of Maxillo Facial Surgery, Pr. STRICKER, C.H.U. Nancy). These cases were chosen among hundred patients annually examined by C.T. scan, for various diseases (dysfunctions of the T.M.J., traumatisms, infections, inflammatory diseases...). These correlations between radiology and surgery about 26 T.M.J. (2 patients underwent surgery only on one side) were: an accuracy with surgical findings for 19 cases (76%); in 6 cases (23%), a meniscus anteriorly displaced, non detected by C.T. scan was found by surgery; 2 cases of meniscus perforations (one in the frontal plane, the other sagittal) were surgical findings; in 1 case, a displacement was under-valued by C.T. scan; in 3 cases, arthrosic changes (1 case of REITER syndroma) were characterized by C.T. scan. The authors emphasize the value and the limits of evaluation of the internal derangements of the T.M.J. with direct sagittal C.T.

Adolescent↗
PubMed1989

[The CT scanner and the temporomandibular joint. Anatomo-radiologic comparisons. Apropos of 14 cases of algodysfunctional of the manducator system].

Among 500 CT scan of temporomandibular joint (TMJ), examined since 1982 by bilateral direct sagittal method (Department of Radiology, Pr. A. TREHEUX, CHU Nancy-Brabois), the authors have retained 14 cases of patients with symptoms related to TMJ's dysfunction cured by surgery (Department of Maxillo Facial Surgery, Pr STRICKER, CHU Nancy). These cases were chosen among hundred patients annually examined by CT scan, for various diseases (TMJ's dysfunctions, traumatisms, infections, inflammatory diseases...). These correlations between radiology and surgery about 26 TMJ (2 patients underwent surgery only on one side) were: an accuracy with surgical findings for 19 cases (76%); in 6 cases (23%), a meniscus anteriorly displaced, non detected by CT scan was found by surgery; 2 cases of meniscus perforations (one in the frontal plane, the other sagittal) were surgical findings; in 1 case, a displacement was under-valued by CT scan; in 3 cases, arthrosic changes (1 case of Reiter syndrome), were characterized by CT scan. The authors emphasize the value and the limits of evaluation of the internal derangements of the TMJ with direct sagittal CT.

Adolescent↗
PubMed1989

[The scanner and the temporomandibular joint; anatomic-radiologic comparisons. Apropos of 26 cases of masticatory apparatus pain-dysfunction syndrome].

Among 500 CT scan of temporomandibular joint (TMJ), examined since 1982 by bilateral direct sagittal method (Department of Radiology, Pr. A. Treheux, C.H.U. Nancy-Brabois), the authors have retained 14 cases of patients with symptoms related to TMJ's dysfunction cured by surgery (Department of Maxillo Facial Surgery, Pr. Stricker, C.H.U. Nancy). These cases were chosen among a hundred of patients annually examined by CT scan, for various diseases (TMJ's dysfunctions, traumatisms, infections, inflammatory diseases...) These correlations between radiology and surgery about 26 TMJ (2 patients underwent surgery only on one side) were: an accuracy with surgical findings for 19 cases (76%); in 6 cases (23%), a meniscus anteriorly displaced, non detected by CT scan was found by surgery; 2 cases of meniscus perforations (one in the frontal plane, the other sagittal) were surgical findings; in 1 case, a displacement was under-valued by CT scan; in 3 cases, arthrotic changes (1 case of Reiter syndrome) were characterized by CT scan. The authors emphasize the value and the limits of evaluation of the internal derangements of the TMJ with direct sagittal CT.

Adolescent↗
PubMed1988

[Plagiocephaly. Craniofacial asymmetry with variable curling-up].

The plagiocephaly syndrome is an asymmetrical cranial deformity due to premature synostosis of a coronal hemi-suture. The predominant alteration is at the spheno-frontal suture. The classification is attempted between the isolated plagiocephaly (P) an plagiocephaly with hypertelorism, on one side, that are to be distinguished from complex asymmetrical cranio-facial deformities. The frontal P. are differentiated from occipital P (pachycephaly) and from mixed hemi-cranial P. The deformity affects the fronto-orbital region situated anterior to the synostosis. The coronal suture incurves around a pivot formed by the lateral orbital pillar and the pterion, giving rise to a set of facial and cranial deformities, variable according to the precocity and the topography of the synostosis. Investigating the syndrome is clinical and radiological. The deformity reveals itself in 88% of cases, the affects are mainly orbital and ophthalmologic. The authors insist on the necessity of a bilateral orbito-fronto-nasal osteotomy, as a therapeutic act that gives better harmony on short and long term; on the other hand, they draw the attention to the importance of abolishing the synostocic lock by the resection of the lesser wing of the sphenoid extended till the superior orbital fissure and the resection of the outher periosteal layer of the dura matter which allows a remodeling effect the growing brain. The results and complications are evaluated on 44 operated children.

Adolescent↗
PubMed1987

[The influence of the masticatory muscles on craniofacial growth. A microsurgical study in the rat].

Possible influence of masticatory muscles on facial growth was investigated in the rat by the formation of several experimental groups: excision of right masseter muscle of right temporal muscle, of both masseter muscles, of both temporal muscles and of both masseter and temporal muscles, section of inferior maxillary nerve and masseter transplantation. Results demonstrated that overall masticatory muscles provided equilibrium of masticatory function, any rupture of this equilibrium producing effects on mandibular growth and that of the facial mass.

Aging↗