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Biomedical subjects

R H Mathog

Publications and source records attributed to R H Mathog.

At least 37 records · Page 2Linked to original sources
PubMed1984

Hazards encountered in management of basal cell carcinomas of the midface.

Basal cell carcinomas often exhibit aggressive and destructive behavior on the midface, with invasion into the orbit, paranasal sinuses, and even the frontal fossa. Minor modifications in surgical procedures for cosmetic considerations may have devastating consequences on the patient's survival. Tumor extirpation should not be compromised by preoperative planning of the method of reconstruction to be used. Margin control intraoperatively with either conventional frozen sections or the fresh tissue Mohs technique is mandatory for success. If any margin is questionable, reconstruction should be delayed at least until permanent sections confirm complete tumor removal. Ten cases are presented and the literature reviewed to emphasize that inadequate initial management probably contributes more to the observed destructiveness of these lesions than histologic aggressiveness or embryologic patterns of the midface.

Aged↗
PubMed1983

Evaluation and correction of combined orbital trauma syndrome.

Injuries to the inferior and lateral orbital walls are traditionally classified as either "blow-out" or trimalar fractures. This simplified system has helped considerably in the understanding of the causes of the two types of injury and methods of repair. Unfortunately, simultaneous occurrence can cause immediate and delayed problems that potentiate each other. Enophthalmos and globe ptosis, in combination with a depressed malar eminence, present a major challenge to the reconstructive surgeon's efforts to achieve satisfactory function and appearance. This paper reports the results of combined orbital floor and lateral wall injuries as an important clinical trauma syndrome. The interaction of the two fractures with regard to pathophysiology, sequelae, and methods of correction will be discussed. A review of cases will be used to describe the authors' techniques of repair, and to illustrate the preferred methods of bone grafting for correction of retrusion and depression of the globe, muscle entrapment and depression of the malar eminence.

Adult↗
PubMed1979

Posttraumatic pseudohypertelorism. (Telecanthus).

Telecanthus was evaluated in a large series of patients with midfacial trauma. Nine patients were selected for detailed analysis of cause, degree of injury, and results of surgical treatment. The evaluation suggests that fractures causing the medial canthal injury are extensive, often resulting in ocular and CNS damage. Late repairs are plagued with difficulty in identification of the ligament and mobilization of soft tissues in the medial canthal area. Satisfactory function and appearance can usually be obtained by early exploration of the injury, reduction of bone fragments, and restoration of the medial canthal ligament to its normal position.

Adolescent↗
PubMed1979

Surgical correction of maxillary hypoplasia.

In this report the pathophysiology of maxillary hypoplasia is reviewed, and two patients who underwent surgical treatment described. Included in the analyses are illustrations and photographs of the face, cephalometric measurements, predictive tracings, and model surgery. Corrective surgical techniques, consisting primarily of LeForte III osteotomies, are presented in detail. Segmental osteotomy of the lower jaw, sliding genioplasty, and augmentation rhinoplasty are discussed and shown as various adjunctive procedures in the correction of associated deformities. Postoperative tracings and photographs are used to illustrate the predictive changes and improved cosmetic and functional results.

Adolescent↗
PubMed1979

Head and neck manifestations of Maffucci's syndrome.

Maffucci's syndrome consists of multiple cutaneous hemangiomas, dyschondroplasia, and often enchondroma. Once considered as a rare disorder, the syndrome has been frequently recognized and reported in the last 20 years. We report a case of multiple neoplasms of the head and neck and review the literature with regard to those manifestations of Maffucci's syndrome in the head and neck area. We also discuss treatment and the potential for malignant change.

Adult↗
PubMed1977

Tympanostomy tube protection with ear plugs.

Protection by ear plugs from water-borne infection was evaluated in 35 patients with "tympanostomy" tubes, tympanic membrane perforations, or mastoid bowls. Stock and custom-made ear plugs were found to be equally effective up to four months during a period of frequent swimming and bathing activities. Infections were only noted to occur in those patients who did not follow instructions on appropriate use of the plugs.

Adolescent↗
PubMed1977

Diagnosis in persistent cerebrospinal fluid fistulas.

Cerebrospinal fluid (CSF) rhinorrhea and otorrhea have presented difficult problems in both diagnosis and management; moreover, the threat of impending meningitis necessitates early localization of the source of the leak. The most common techniques for evaluation and isolation of CSF rhinorrhea and otorrhea have included X-ray studies, intrathecal dyes, and radioactive cisternography...

Adolescent↗
PubMed1977

Comparison of caloric and sinusoidal tests in the vestibulotoxic cat.

In order to evaluate the relative sensitivity of caloric and sinusoidal angular acceleration tests, thermal and rotational stimuli were administered to cats rendered vestibulotoxic with streptomycin sulfate. Three groups of six cats each, receiving daily subcutaneous injections of saline, 100 mg/kg streptomycin or 200 mg/kg streptomycin, were administered optokinetic, caloric and sinusoidal stimuli. Vestibular responses were evaluated by changes in the total slow phase displacement of the eyes and frequency of nystagmic beats. The results demonstrated that the saline treated animals had a decrease in response consistent with habituation; whereas, experimental animals showed a marked, rapid abolition of eye movement. The decrease in response was greater for the larger dose of streptomycin. Caloric or sinusoidal acceleration tests were equally sensitive in monitoring the degree of nystagmic depression. The data suggested that sinusoidal acceleration tests could be easily applied to the clinical vestibular assessment of ototoxicity.

Animals↗
PubMed1976

Effects of hemodialysis on hearing threshold.

71 chronic renal failure patients undergoing long-term hemodialysis were evaluated for the effects of a dialysis event on hearing function. Osmotically active serum constituents were examined for relationship to fluctuating hearing threshold levels. Reliabiliity of hearing levels was found to be better in those patients tested without an intervening dialysis event. Those patients tested before and after hemodialysis demonstrated greater hearing fluctuation than those patients evaluated between dialysis events. This threshold fluctuation was unrelated to serum urea nitrogen, creatinine, K+, Na+, Ca++, or glucose. It was concluded that hearing test reliability in dialyzing renal patients is resonably good, but test results are likely to be more consistent if testing is accomplished a number of hour after a given dialysis event. Contrary to a number of reports in the recent literature, no direct relationship between hearing level fluctuation and fluctuation in individual osmotically active serum constituents appeared to be present.

Adult↗
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

Complications in the treatment of facial fractures.

The evaluation and treatment of the more common and severe complications of facial fractures are reviewed. This analysis includes such conditions as nonunion and malunion of the maxilla, mandible, and zygoma, temporomandibular ankylosis, diplopia, enophthalmos, hypertelorism, dacrocystitis, and cerebrospinal otorhinorrhea. The discussion attempts to stress the importance of diagnosis regarding cosmesis and functional abnormalities. When possible, the pathophysiology is elucidated and evaluated to decide about methods of prevention. Preferred traditional and improved techniques of management are noted and compared to some of the less satisfactory procedures.

Ankylosis↗
PubMed1974

Scar revision.

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Cicatrix↗