Kent prosthesis.
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Biomedical subjects
Publications and source records attributed to R Hensher.
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A case is reported of a malignant melanoma presenting in a parotid gland with no other primary lesion detectable. The pathological feasibility of primary malignant melanoma of the parotid is discussed together with a review of the literature.
The apical root resection of mandibular molars is an operation seldom performed and then one limited primarily to the lower first molars. Although the first paper on this topic was published at the beginning of the 20th century, little progress has been observed since then. This is due to the thickness of the buccal bony plate in the lower molar region which makes surgery very difficult and leads to a substantial loss of bone. The resultant limitation of the operating field prevents good vision. The aim of our approach is to minimize or to eliminate these problems by opening a bony lid above the roots which are to be resected. This can be made large enough for the surgeon to have easy access and good vision during apical surgery. At the end of the operation the same lid is replaced in order to avoid a bony defect and to facilitate the healing process. Of the 75 patients treated using this technique during a 3-year period, only one post-operative complication has been observed. A complete healing of the bone was observed in the majority of cases within 6 months.
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The temporalis muscle flap recently has become widely used in reconstructive surgery of the maxillo-facial region, although it was described around the turn of the century. We review the work which led to its development, and to illustrate its versatility, we describe some of its uses.
Primary parotid actinomycosis is extremely rare. Two patients are discussed in whom this disease presented quite differently. The literature is reviewed and the management described, with particular reference to antibiotic therapy.
Hydroxylapatite implants are becoming widely used, but this new material is not without its drawbacks. These mainly concern its physical characteristics, complicating and limiting its clinical applications. A method of altering these with fibrin adhesives is described and early laboratory and clinical experience is presented.
A case is described in which localising neurological signs developed on the first day following general anaesthesia for insertion of a silastic implant over a frontal fracture. Despite prompt appropriate investigation seven weeks elapsed before the correct diagnosis was made. Aspects of the management of patients who develop a neurological deficit soon after general anaesthesia are discussed.
Oral polio vaccine (OPV) has been used in the Gaza Strip since 1968. Although vaccine coverage had reached 80 to 90% of the infant population, the epidemiological pattern of the paralytic disease had not changed significantly as of the beginning of this study. The mean annual incidence continued to be around 10/100,000. Two outbreaks occurred, in 1974 and 1976, involving 75 and 77 children, respectively, an incidence of 18/100,000. In these two outbreaks, 34 and 50% of the affected children, respectively, received 3 to 4 doses of OPV. A serological survey done after a vaccination campaign with monovalent Type 1 vaccine showed an unexpectedly low percentage of seropositives. A parallel was found between the prevalence of diarrheal disease and vaccine failure, and a causal effect was postulated. To overcome this problem, a program of immunization was started early in 1978 combining both live and killed polio vaccines. Although cases of polio continue to appear, the incidence has been reduced to 2.4/100,000 population. In 1981, only one case was reported, in an unvaccinated child. Thus, it would seem that the new vaccination schedule combining live and killed vaccines makes eradication of polio a possibility.
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Temporomandibular joint replacement is a small area in maxillofacial surgery but of great importance. The treatment of severe temporomandibular disease with prosthetic joints can produce enormous benefit to patients and the current status of this technique is discussed here.