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Biomedical subjects

V V Strelzow

Publications and source records attributed to V V Strelzow.

18 recordsLinked to original sources
PubMed1995

Reconstruction of the base of the tongue with the microvascular ulnar forearm flap: a functional assessment.

Ten patients with infiltrating carcinomas of the base of the tongue/tonsillar region underwent 30 to 100 percent resection of the base of the tongue and lateral pharyngeal wall. The surgical defect was reconstructed (9 primary, 1 secondary) with a large microvascular ulnar forearm flap that was selectively contoured to provide bulk for the base of the tongue and a thin lining for the pharyngeal wall. Seven patients were evaluated for swallowing and speech 6 weeks to 2 years following the reconstruction. Cineradiographic studies showed excellent base of the tongue and flap mobility allowing glossopharyngeal closure in all patients and complete pharyngeal evacuation in four patients. Four patients who were in good health preoperatively were able to eat a regular diet postoperatively, and the remaining three patients were able to handle soft food. Functional recovery after major tongue base surgery is contingent upon a three-dimensional microvascular reconstruction using a thin forearm flap.

Aged↗
PubMed1988

Cephalometric airway analysis in obstructive sleep apnea syndrome.

In obstructive sleep apnea syndrome, polysomnograms characterize the nature and severity of the disorder but, rarely, its specific site. Therefore, 90 patients with documented obstructive sleep apnea were evaluated by cephalometric technique, with special attention paid to the size and position of the soft palate and uvula, volume and position of the tongue, mandibulo-maxillary relationship, hyoid position, and size of the pharyngeal airway space. Results showed major differences between control patients and patients with obstructive sleep apnea in over 50% (30/52) of the objectively measured indices of the cephalometric airway. Further, many changes in the cephalograms of these patients can be correlated with disease severity.

Adult↗
PubMed1983

Reconstruction of the paralyzed face with the polypropylene mesh template.

Several techniques for static suspension of soft tissues in facial paralysis are available, including this use of the polypropylene (Marlex) mesh template. Through a standard rhytidectomy, lip and melolabial incisions, this template can be attached to the pivotal facial suspension points to bring about a selective and adjustable redistribution of the facial soft tissues. Although not meant to replace autogenous tissue use or physiologic reanimation procedures, this technique proved to be useful in three selective cases. The functional and cosmetic consequences of the polypropylene mesh template insertion on both a model and on three clinical patients with unilateral facial paralysis illustrate this technique. The concept of facial suspension along with its limitations, especially as it relates to template use and static facial suspension, are discussed.

Adult↗
PubMed1983

Mandibular reconstruction using implantable stabilization plates.

The consequences of substantial mandibular loss usually are disturbances in mastication and often in cosmesis. In an attempt to arrive at an easy and reliable technique of reconstructing mandibular defects, a selected group of patients were treated using rigid, implantable reconstruction plates. These were used to provide continuity and stability for the residual mandible with or without the use of graft materials. These have included autogenous fresh, irradiated, or frozen bone, and polytetrafluoroethylene carbon fiber sponge (Proplast). A discussion of the principles and technique of using reconstruction plates is outlined.

Aged↗
PubMed1983

Osteosynthesis of mandibular fractures in the angle region.

The region of the angle of the mandible is one of the most frequent sites of fracture in external mandibular trauma. In 14 cases of fracture through the angle region, angled dynamic compression plates inserted through an extraoral route were used to provide rigid internal fixation. This method often obviates the need for intermaxillary fixation and suggests a technically simple technique by which direct and uncompromised healing of angle fractures with good resultant occlusion can be achieved in selected cases. We outline our current technique and the indications and limitations for using angled dynamic compression plates.

Adolescent↗
PubMed1983

Current management of cerebrospinal fluid rhinorrhea.

Forty-two patients with cerebrospinal fluid (CSF) rhinorrhea presenting over a 5 year period were analyzed as to age, sex, etiology, anatomical and clinical findings, and methods of investigation and treatment. Eighty-eight were traumatic in origin, with the most common anatomical sites being ethmoid, frontal and sphenoid sinuses, and the cribriform plate region. Meningitis and pneumocephalus were the most frequently associated clinical findings each present in 31% of the cases. Chemical analysis of the CSF for protein was positive in 88% of cases vs. 13% when the protein content was quantitatively analyzed. The demonstration and localization of CSF leaks were most effective using metrizamide and CAT scanning when they were active and by indium cisternography when they were small, intermittent, or questionable. The clinical management was divided into medical and surgical approaches with the advantages and disadvantages discussed.

Adolescent↗
PubMed1982

Dynamic compression plating in the treatment of mandibular fractures. Early experience.

The production of rigid fracture fixation has most recently been carried out by the use of internal compression plates. These allow for a simple and accurate method of providing either static or dynamic osteosynthesis in a variety of maxillofacial applications. Especially in cases involving the edentulous mandible, in comminuted fractures with or without loss of bone, in fractures where intermaxillary fixation would be necessary, or when internal splinting is required, this technique as presented may offer some unique and desirable advantages. An overview of the general principles and technique is presented and discussed.

Adolescent↗
PubMed1982

The surgical closure of nasoseptal perforations.

Although nasoseptal perforations are uncommon--becoming even more so with early diagnosis and treatment of nasal trauma along with continuing refinements in septal surgery--a myriad of suggested techniques continue to exist for their closure. The conventional success rate is often unacceptably low so that Silastic prostheses are now being used to relieve the symptoms of septal perforation. The successful surgical closure of perforation of the nasal septum is still difficult. This treatment has been greatly facilitated by the use of the external rhinoplasty, without compromising the airway or causing cosmetic deformity. Supportive autogenous graft material is used routinely, while the perforation is closed using bilateral, bipedicled mucoperichondrial flaps. This paper omits a complete discussion of etiology. The indications for surgical correction are discussed in detail. The main contraindication to attempting correction is the size and the position of the perforation. The paper is based on 7 years' experience during which period 18 patients have had this surgery. The technical details of the operation are described with the aid of diagrams and photographs.

Humans↗
PubMed1981

Stylohamular dissection: a new method for en bloc reaction of malignancies of the infratemporal fossa.

This study is a description of the "stylohamular" dissection, a technique for the en bloc resection of the infratemporal fossa. The medial plane of this dissection extends from the styloid process to the hamulus of the pterygoid just lateral to the foramen lacerum, allowing the surgeon to spare the internal carotid artery. The foramen ovale and foramen spinosum are routinely exposed during this procedure. Medially, the pterygoid musculature serves as the margin of the cancer block. Posteriorly, the mastoid tip may be included in this resection. Anteriorly, the lateral pterygoid plate is resected making it the anterior vertical plane of the dissection. Laterally, skin and mandible are the block margins. In the last three years, this approach has been utilized in eight patients with advance malignancies involving the infratemporal fossa. The results are encouraging. Five patients have remained well and free of disease for a maximum of three years postoperatively. Two patients have had recurrence of their tumor from six months to one year postoperatively. Palliation in all patients was excellent. The literature on various infratemporal dissections and their results is reviewed.

Adult↗
PubMed1980

Nape of neck flap.

Great advances in the field of reconstructive head and neck surgery have been made in the last 20 years, and although the nape of neck flap has not been used as frequently as the deltopectoral flap or the forehead flap, its contribution in this field has been significant. This paper discusses the flap's history, anatomical basis, and clinical applications. Advantages, disadvantages, and complications are discussed and the flap's role in modern head and neck reconstructive surgery is examined.

Adult↗
PubMed1979

Infections of the temporomandibular joint.

Three interesting case histories of infection of the temperomandibular joint are reported. An unsuccessful search of the recent literature was made in the hope that some assistance would be obtained in understanding the pathology. These infections must have been more common in the pre-antibiotic era and perhaps a search of the older literature would have been more fruitful.

Abscess↗
PubMed1978

Nasoseptal perforation--closure by external septorhinoplasty.

The successful correction of perforations of the nasal septum is still difficult. This treatment has been greatly facilitated by the use of the external septorhinoplasty, without compromising the airway or causing cosmetic deformity. Supportive autogenous graft material is used routinely and bipedicled mucoperichondrial flaps are used when necessary. Seven consecutive patients have been successfully treated by this method.

Adult↗
PubMed1978

Pre- and postoperative management of the rhinoplasty patient.

The role of the otolaryngologist has widened to include facial cosmetic surgery. As such it encompasses all aspects of age-diminishing surgery as well as facial contour augmentation, surgical and traumatic scar camouflage, and otoplasty as well as rhinoplasty. It necessarily follows that the rhinoplasty surgeon must view the total face rather than the nose in isolation. A complete understanding of the indications and contra-indications of rhinoplasty is necessary for adequate pre- and postoperative assessment of the patient. These ideas are developed and the analysis of the nasal pathology is discussed.

Adolescent↗
PubMedDate not supplied

Secondary microvascular tongue reconstruction: functional results.

Between 1978 and 1991, 56 microvascular composite flaps were used for oromandibular reconstructions: 15 for primary total and subtotal tongue reconstruction and five for secondary major tongue reconstruction. The delayed reconstructions were performed to improve the oral and pharyngeal phases of swallowing. Using a floor of the mouth composite bone grafting technique to reposition the tongue and obliterate the oral dead space intraoral food transport was improved (three of five patients), but aspiration persisted (three of four patients). When compared with 10 patients evaluated for primary total and subtotal tongue reconstruction the primary reconstruction group showed superior swallowing (eight dynamic oral transport, no aspiration) and speech results. The poor results of secondary reconstruction are attributed to scarring and irreversible damage to remaining functional muscles involved in protecting the laryngeal aditus.

Aged↗
PubMedDate not supplied

Reconstructive versatility of the pectoralis major myocutaneous flap.

The pectoralis major myocutaneous flap is presented in its two basic forms: a muscle flap carrying a skin paddle and the continuous skin-muscle flap technique. The pertinent anatomy of the enveloping fascial planes is reviewed, stressing the increased latitude of safety afforded by elevating the vascular pedicle from the undersurface of the lateral muscle edge. The advantages of a deltopectoral flap outline in approaching the formation of the skin-muscle paddle are introduced. Clinical applications, advantages, and disadvantages are discussed.

Humans↗
PubMedDate not supplied

Xeroradiography in revisional septorhinoplasty.

Because of the continuing increase in the popularity of cosmetic nasal surgery, the revision of previous augmented septorhinoplasties has become more common. With the use of autogenous grafts and the popularization of several synthetic implant materials, a correct preoperative evaluation of the augmented nasal dorsum has become more difficult. Several such patients were examined using conventional soft tissue roentgenograms and xerograms. The latter method produced an improved image of the nasal skeleton when compared with the conventional soft tissue examination. The support for this conclusion is provided by clinical photographs, x-rays films, and xerograms of illustrative cases.

Adolescent↗
PubMedDate not supplied

Antro-ethmosphenoidectomy.

A technique of antro-ethmosphenoidectomy has evolved over the last 50 years to provide a thorough, yet safe method of treating chronic, recurrent advanced pansinusitis. The trans-antral approach to the ethmoid labyrinth and sphenoid sinuses was first described before the turn of this century. A brief chronological history is reviewed in order to understand the development and then the abandonment of this surgery for over twenty years. This was followed by a renewed interest in the procedure conforming to the modern concepts of nasal physiology and rhinologic surgery. Because of the wide visual surgical exposure, the antro-ethmosphenoidectomy approach is most ideally adapted to pituitary, skull base and orbital decompression procedures.

Ethmoid Sinus↗