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Biomedical subjects

S J Siemssen

Publications and source records attributed to S J Siemssen.

At least 19 recordsLinked to original sources
PubMed1997

Osseointegrated implants for prosthetic rehabilitation after treatment of cancer of the oral cavity.

The treatment of oral cancer usually involves extensive resection of the mandible, excision of oro-facial soft tissue and often radiotherapy. This causes difficulty in the subsequent oral rehabilitation. The present paper reports our experience with implant treatment of this patient group. The material comprises 38 implants in 12 patients. Four patients died during follow-up, two before loading the implants. The observation time after implantation was 7 to 47 months with a median of 14 months. Six of the patients had been subjected to preoperative radiation therapy. All 38 implants osseointegrated without complications. It is concluded that healing after implantation in irradiated mandibles can be achieved without hyperbaric oxygen. Provided certain guidelines are complied with i.e. careful surgical technique, use of antibiotics and prolonged period of healing prior to loading of the implants, a radiation dosage of up to 50 Gy appears to be of little significance.

Adult↗
PubMed1993

[Microvascular reimplantation of the penis].

A case of autoamputation of the penis is presented. Although the unique vascular properties of the penis have permitted good results in a number of cases of amputation of the penis, it is certain that the use of microreimplantation gives better results with a minimum of postoperative complications.

Adult↗
PubMed1993

Importance of the time interval between radiotherapy and surgery in oral cancer.

From 1969 to 1985, 62 patients with squamous cell carcinoma of the oral cavity received preoperative radiotherapy (RT) 40-50 Gy before radical surgery. The time interval between the end of the RT and surgery varied from 4 to 49 days (median 19 days). The cancer specific survival rate was significantly lower for the 32 patients with intervals longer than or equal to 19 days compared with patients with shorter intervals (P = 0.001). The reason for choosing a longer interval between the treatment modalities was not related to stage or performance status, however, a possibility that patients in poor condition were preferentially allocated to the long intertreatment interval group cannot be ruled out. This study suggests that when using combined modalities any effort should be exercised to reduce the time interval between the modalities.

Adult↗
PubMed1987

On the occurrence of necrotising lesions in arteritis temporalis: review of the literature with a note on the potential risk of a biopsy.

Against the background of a steadily growing proportion of elderly individuals within the populations in the Western countries, arteritis temporalis with its wide diversity of presenting symptoms in the elderly patient, including purely psychiatric ones, has become a disease of increasing interest to the medical profession. Increasing demands may be made on the surgeon, often a plastic surgeon, responsible for carrying out the biopsy that is necessary in arteritis temporalis for both diagnostic and therapeutic reasons. Attention is called to certain elements of risk inherent in taking a biopsy of an artery under local anaesthesia, and to the fact that the administration of ergotamine tartrate may provoke serious complications in this particular disease.

Aged↗
PubMed1985

Muscle transposition for treatment of osteomyelitis of the tibia.

A series of 24 consecutive patients with osteomyelitis of the tibia and soft tissue defects were treated according to the principle of radical excision of the infected bone together with transposition of muscle flaps and primary skin cover as a one-stage procedure. External fixation was used for stabilization of bone. The mean duration of osteomyelitis before radical operation was 72 weeks and the previous stay in hospital averaged 15 weeks. Twenty-one patients had previously undergone 3.7 operations because of the infection. Staphylococcus aureus was cultured in 50% of the patients, while no bacteria could be identified in six patients. Appropriate antibiotics were given for an average of eight weeks. In four patients a secondary bone transplant and in three patients another skin transplant was necessary. One patient refusing further reconstructive surgery insisted on an above-knee amputation because of persisting infection. After an average observation time of 2 1/2 years no infection or instability of the tibia could be demonstrated, but one patient showed two small skin defects. These results indicate that radical excision of infected bone in combination with muscle transposition and primary skin cover is effective in the treatment of posttraumatic osteomyelitis of the tibia.

Adolescent↗
PubMed1984

Aggressive fibromatosis (extra-abdominal desmoids) of the head and neck.

Five cases of aggressive fibromatosis of the head and neck area (extra-abdominal desmoids) are presented. The clinical and histological character of local aggressiveness of these tumours is emphasised. Radical surgery, when feasible, is the only satisfactory form of treatment. Excision of as much tumour tissue as preservation of vital structures in the area will permit can also offer worthwhile palliation.

Adolescent↗
PubMed1983

Reconstruction of the floor of the orbit following subtotal maxillectomy by transposition of the septal wall as a local flap.

The use of the septal wall for restoring defects of the orbital floor following subtotal maxillectomy is described. In our experience this method provides: A viable, easily adaptable, mainly bony wall (perpendicular plate and vomer) that allows the surgeon to adjust the displaced eyeball. The possibility of re-adjustment of a secondarily sunken eyeball, with loss of binocular vision, by means of a Silastic implant, the transposed septal wall offering sufficient resistance. A substantial contribution to the hygiene of the resection cavity by introducing an actively secreting mucous membrane as part of the lining. In addition a modification of the Fergusson-Weber incision is described.

Female↗
PubMed1982

Speech rehabilitation in total paralysis of the tongue.

A 31-year-old woman attempted suicide by cutting her throat. In doing so, she severed the hypoglossal nerves bilaterally. The patient received full speech rehabilitation following nerve suture and logopedic training. The surgeon who is faced with deep wounds of the anterior part of the neck, especially cut wounds (due to accident, suicide, or murder), should be aware of the possibility of a severance of the hypoglossal nerve, and perform surgical exploration of the tongue later when a paralysis of the tongue has been diagnosed with the aim of doing a nerve suture. With modern technique, interfascicular suture under the microscope, not only tonus of the tongue is likely to be recovered, but also some degree of more differentiated motility that would shorten the period of convalescence and reduce the need for logopedic training.

Adult↗