Biomedical subjects
Publications and source records attributed to R Pilcher.
Three patients with paragangliomas of the head and neck region were referred to an oral and facial unit during a 16-month period. Because such lesions are rare, it was not initially considered in the differential diagnosis. This paper reviews these tumours and stresses the importance of including them in the differential diagnosis of a neck mass.
Rapid evacuation from the scene of injury, the Advanced Trauma Life Support (ATLS) protocol and advancements in medical and surgical practice afford high standards of care for maxillofacial gunshot wounds (GSWs). This series of nine case reports illustrates both the changes that have occurred and the similarities that remain in the management of these wounds since the First World War. It serves as a reminder of the problems that may be faced managing maxillofacial injuries both in a future conventional war and also increasingly in the civilian population.
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A case of basal cell naevus syndrome is presented. The jaw cysts were proved histopathologically to be odontogenic keratocysts. The multiple naevoid lesions on the skin were identified as basal cell carcinoma. Intracranial calcification is illustrated to a degree not previously reported in a case with this syndrome. The importance of identifying this syndrome is discussed and its presentation in the Falkland Islands is reported.
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The jaw-jerk response was elicited in seven adult male subjects by tapping on the chin in a downward direction. The magnitude of the applied taps was varied subjectively by the operator, and the downward acceleration of the mandible measured by means of a calibrated piezo-electric accelerometer fixed to the lower anterior teeth. The taps were applied during voluntary clenching by the subject, controlled by means of a force transducer placed between upper and lower teeth. The electrical response of masseter and temporal muscles was found to increase both with increasing stimulus strength and with voluntary clenching force. However, only by averaging a number of responses were clear relationships demonstrated, there being other variables, affecting the muscles independently, which it has not been possible to identify and control. It is concluded therefore, that quantitative analysis of the electromyograms of the jaw closing muscles following chin-tap stimuli is not a satisfactory method for testing for abnormality in excitability of the neuromuscular system involved in the jaw-jerk response.
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