PubMed Health⌕ Search

Biomedical subjects

M W Ochs

Publications and source records attributed to M W Ochs.

At least 19 recordsLinked to original sources
PubMed1999

The use of maxillary sinus endoscopy in the diagnosis of orbital floor fractures.

PURPOSE: The goal of the current study was to evaluate the ability to diagnose the presence of an inferior orbital wall fracture through the use of a transantral endoscopy technique at bedside. PATIENTS AND METHODS: Seven trauma patients with initial axial computed tomography (CT) scan findings consistent with an orbital floor fracture were studied. Before endoscopy, the patients underwent a coronal CT scan with 3-mm cuts for later comparison with the endoscopic findings. The surgeon performing the endoscopy procedure was blinded to the results of the coronal CT scan. Visual acuity, intraocular pressure, and measurement for enophthalmos were performed before endoscopy. The endoscopic procedure was performed at the bedside using local anesthesia. A trocar was used in the canine fossa to gain access to the maxillary sinus. A 30 degrees and then a 70 degrees endoscope were introduced through the trocar to evaluate the integrity of the orbital floor (ie, maxillary sinus roof). The degree of mucosal injury of the orbital floor and the presence of blood or orbital contents in the sinus were recorded. The ophthalmologic examination was repeated after completion of endoscopy. RESULTS: The endoscopic procedure was able to be completed in all patients. There was no change in the ophthalmologic examination in any patient as a result of endoscopy. In six of the seven patients studied, the endoscopic findings correlated with the need for surgical intervention to repair the orbital floor predicted on the basis of coronal CT scan. This was determined by the degree of injury to the orbital floor and the presence of hematoma, exposed bone, or fat. In the remaining case, endoscopy was not diagnostic for the presence of a fracture because only ecchymosis of the orbital floor was noted. CONCLUSIONS: The ability to perform endoscopy under local anesthesia at the bedside is useful in those trauma patients whose concomitant injuries may prohibit other diagnostic modalities.

Adolescent↗
PubMed1998

Management of avulsive injuries of the nasal bones: review of the literature and three case reports.

Blunt contusions, lacerations, and avulsion-type trauma are the most often reported nasal injuries sustained in motor vehicle accidents. The nasal skeleton and soft tissues are frequently involved and may require surgical repair of the injuries. The primary reconstruction often requires the use of autogenous grafts, and secondary revision surgery may be necessary. The treatment may require a multidisciplinary surgical team or a single surgeon who knows how to manage the injury. Optimally, the reconstruction of nasal bone avulsions is performed primarily, using autogenous graft materials. This article presents reconstruction of the nasal deformities in 3 patients involved in motor vehicle accidents. The authors describe and evaluate the various graft materials and surgical techniques utilized. The advantages and disadvantages of autogenous and alloplastic materials are discussed. Studies with more patients and long-term follow-up are required for a definitive evaluation.

Accidents, Traffic↗
PubMed1996

The effects of guided tissue regeneration and fixation technique on osseous wound healing in rabbit zygomatic arch osteotomies.

The development of fibrous nonunions after craniofacial surgery is thought to result from an interaction of biomechanical stress and the differential migration of various tissue types into the wound site during healing. The present study is designed to test this hypothesis through the manipulation of guided tissue regeneration and osteotomy fixation techniques in an experimental rabbit model. Bilateral, critical size (5 mm), vertical osteotomies (n = 32) were produced in the zygomatic arches of eight adult rabbits. The mobile bony segments were fixed rigidly or nonrigidly using bone microplates and screws or osteosynthetic wires. The defects were then covered with a resorbable collagen membrane or left uncovered. The rabbits were followed for 4 weeks with serial dorsoventral cephalographs and the zygomatic arches harvested for histological analysis. Cephalometric results revealed significantly (p < 0.001) increased bone growth in the margins of the defects covered with the collagen membrane; however, no significant (p > 0.05) differences were noted between fixation techniques. Histological analysis revealed that defects fixed rigidly and covered by the membrane showed the most rapid and organized osseous wound healing, followed by the defects that were fixed nonrigidly and membrane covered. The defects not covered by the collagen membrane showed invasion by fibroblasts resulting in fibrous nonunions. These results demonstrate the efficacy of guided tissue regeneration with a resorbable collagen membrane in preventing fibrous tissue ingrowth in large bony defects. The addition of rigid fixation at a potentially mobile site appeared to enhance bony trabecular organization but not the osteogenic rate in this rabbit model.

Animals↗
PubMed1995

Nuclear dacryoscintigraphy: its role in oral and maxillofacial surgery.

Obstruction of the lacrimal drainage apparatus may result in excessive tearing or epiphora. This may occur as a result of a traumatic injury or accumulation of debris, mucus, or pus. In nuclear dacryoscintigraphy, a radioactive solution is introduced into the conjunctival sac by pipette and allowed to follow the flow of the tear solution through the lacrimal drainage system. This article will review normal lacrimal anatomy and indications for nuclear dacryoscintigraphy in oral and maxillofacial surgery.

Humans↗
PubMed1995

Intraoperatively fabricated bite block in the management of scar contracture hypomobility.

Intraoral surgical procedures produce scar tissue formation that may limit mandibular opening. Many procedures have been developed to release these scar contractures, but most lead to further scar formation and greater limitation in opening. The purpose of this article to describe a technique with the use of an intraoperatively fabricated self-curing acrylic bite block combined with aggressive physical therapy in the management of this difficult clinical problem.

Adult↗
PubMed1995

Management of condylar fractures in children: review of the literature and case presentations.

The treatment of mandibular condylar fractures has remained a controversial subject. Although many fractures can be treated by closed reduction with subsequent physiotherapy, others are treated by open reduction and rigid internal fixation. The management of these fractures in children and adolescents is more controversial. This article will review the treatment options for condylar fractures in children along with indications and contraindications for open repair.

Adolescent↗
PubMed1994

Complex facial fractures in the periorbital region.

Recognition of periorbital facial fractures with appropriate clinical and diagnostic evaluation is essential for surgical decision making. Treatment planning should be directed at correcting any demonstrable functional problem or cosmetic deformity. The radiographic presence of a fracture line should not be the sole criterion for surgery. When surgical intervention is indicated, early repair will usually provide a more favorable result.

Facial Bones↗
PubMed1993

Current concepts in management of facial trauma.

Open reduction and internal fixation have become routine in facial fracture treatment. Methodical evaluation and treatment planning should be based on the patient's injuries, extenuating factors, and the surgeon's experience. After initial treatment, patients with facial trauma may require orthodontic alignment of teeth, endodontic therapy, osteotomies, implants, vestibuloplasties, and scar revisions to achieve an acceptable functional and cosmetic result. The oral and maxillofacial surgeon is best qualified to coordinate and help deliver this interdisciplinary approach to treatment.

Adult↗
PubMed1993

Indications for enteric tube feedings in oral and maxillofacial surgery.

The catabolic effects of surgical trauma and sepsis have long been recognized. Oral and maxillofacial surgical patients represent a unique group in that their surgery and its effects on the stomatognathic system may adversely affect the ability to receive adequate nutrition. This article discusses some basic nutritional principles and describes the indications and guidelines for enteric tube feeding in this patient population.

Basal Metabolism↗
PubMed1993

Trigeminal neuralgia: review of etiologies and treatments.

Numerous etiologies have been proposed for the pathogenesis of trigeminal neuralgia. For each proposal, there has been an overabundance of management protocols, ranging from pharmacological therapy to craniotomy with microvascular decompression. In addition, several orofacial pain disorders can be confused with trigeminal neuralgia, which makes the diagnosis and management more difficult. This article will discuss the many currently accepted etiologies of trigeminal neuralgia, their respective treatments, and similar orofacial pain disorders.

Humans↗