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Biomedical subjects

B N Epker

Publications and source records attributed to B N Epker.

At least 37 records · Page 2Linked to original sources
PubMed1991

The aged face: the facial manifestations of aging.

Traditionally, cosmetic maxillofacial surgery designed to rejuvenate "the aged face" has been reserved for the elderly. However, any patient with facial manifestations that reflect, but are not limited to, an increased chronologic age is a candidate for esthetic maxillofacial surgery. In this text, the aged face refers to any facial manifestations that are perceived as indices of advanced age beyond an individual's chronologic or desired age. This paper presents a brief outline of the specific facial features that account for the aged face and describes surgical correction.

Adult↗
PubMed1990

The modified superior based pharyngeal flap. Part I. Surgical technique.

The superior based pharyngeal flap operation for the correction of velopharyngeal incompetence is perhaps the most commonly employed operation used today in a majority of cleft palate centers. However, inconsistent results with this operation are commonplace. This is believed by most to be due to poor control of the lateral portals. Herein is a report of our approach to improve lateral portal control.

Airway Obstruction↗
PubMed1990

The modified superior based pharyngeal flap. Part III. A retrospective study.

A retrospective study of 31 patients who had diagnosed velopharyngeal incompetence and were surgically managed with the modified superior based pharyngeal flap was completed. The following were analyzed: age at time of operation, gender, physical status, diagnostic protocol, length of operation (length of total surgery) and length of superior based pharyngeal flap, length of postoperative hospital stay, length of total hospital stay, length of follow-up, speech results, complications, patient care, and medication. The result showed that the optimal timing for correction of velopharyngeal incompetence was between 3 and 6 years of age. The mean length of total hospital stay was 2.7 days, postoperative complications were minimal, and speech results were generally good.

Adolescent↗
PubMed1989

Clinical neurosensory testing: practical applications.

A relatively large percentage of the practicing oral and maxillofacial surgeon's patients experience some degree of neurosensory impairment as a normal concomitant of major surgery. Additionally, some patients develop neurosensory disturbances unexpectedly following routine surgical procedures. This report describes a practical approach to evaluating these individuals, which is essential in making intelligent decisions regarding the objective nature of the nerve injury, potential for recovery, and/or possible need for secondary microneurosurgical intervention.

Humans↗
PubMed1989

Reconstruction of frontal and frontal-nasal deformities with prefabricated custom implants.

The use of prefabricated custom silicone rubber implants for frontal and nasofrontal deformities produces predictable esthetic results with minimal operative and postoperative morbidity and/or complications in selected patients. Over the past 8 years, 15 custom silicone rubber implants have been placed with good to excellent results. Only one implant was removed due to postoperative infection. This implant was successfully replaced upon resolution of the infection.

Adolescent↗
PubMed1989

Predictability of upper lip soft tissue changes with maxillary advancement.

To improve predictability of the esthetic (soft tissue) results after maxillary advancement surgery, a better understanding of the relationships between the dental osseous movement and overlying soft tissue response is essential. Twenty-one adult patients who underwent isolated maxillary advancement via LeFort I osteotomies without adjunctive nasal soft tissue procedures and/or V-Y closure of the vestibular incision were studied. Homogeneity of the patient population was ensured by selecting cases with less than 2 mm vertical change. The mean maxillary advancement and mean change in Sn was calculated for these 21 patients. Additionally, the 21 patients were subdivided into two groups based on lip thickness: group 1 (lips between 10 and 17 mm thick) and group 2 (greater than 17 mm thick). In each patient group a linear regression (LR) was determined on the magnitude of maxillary advancement (MMA) to the change in soft tissue subnasale (Sn) and on the ratio of Sn change to bone move. The results using mean data showed that the relationships produce significantly high standard deviations; thus, a general correlation between change in soft tissue position to bony advancement cannot be made. Individuals with thin lips (12 to 17 mm) had a good correlation between the magnitude of bony move and amount of soft tissue change. However, increased lip thickness (greater than 17 mm) produced a less predictable correlation between soft and hard tissue changes. All lips thinned around 2 mm when compared with preoperative values. Lip thickness stabilized at approximately 6 months postoperatively.

Adult↗
PubMed1989

Transoral submental lipectomy: an adjunct to orthognathic surgery.

Individuals undergoing the surgical correction of dentofacial deformities are becoming both older and more discriminating. Consequently, they often request specific esthetic improvements. To meet the desires of such patients, adjunctive surgical procedures to the planned orthognathic surgery are becoming more commonplace. One of the more frequent procedures performed is the transoral submental lipectomy. This article discusses the evaluation of the submental region, the indications for transoral submental lipectomy, and the surgical technique. Several case indications illustrate the results of this procedure.

Chin↗
PubMed1988

Anatomic-histologic survey of the sural nerve: implications for inferior alveolar nerve grafting.

An anatomic and histologic study of the sural nerve was made as part of an effort to formulate a rationale governing selection of appropriate segments of the nerve as a donor graft for repair of the inferior alveolar nerve. Ten sural nerves were obtained by dissection at autopsy and their topography assessed. Hematoxylin and eosin stained transverse sections were prepared from samples taken at 32 locations along each nerve. Nerve diameter and shape, fascicle number, and fascicular arrangement were assessed at low power using light microscopy. It was concluded that technical objectives of graft repair can be better attained by selective sural nerve harvest.

Adult↗
PubMed1987

Nerve sharing by an interpositional sural nerve graft between the great auricular and inferior alveolar nerve to restore lower lip sensation.

A case of bilateral nerve sharing via an autogenous sural nerve graft interposed between the ipsilateral great auricular nerve and the inferior alveolar nerve was used to restore sensation to the lower lip. To our knowledge this is the first report of successful nerve sharing between a sensory branch of the cervical plexus and the inferior alveolar nerve.

Adult↗
PubMed1986

Control of the condylar-proximal mandibular segments after sagittal split osteotomies to advance the mandible.

Maintenance of the normal or presurgical anatomic position of the mandibular condyles and contiguous proximal mandibular ramus segments after sagittal split ramus osteotomies is important, not only to enhance the stability of results but also to avoid iatrogenic temporomandibular joint complications. Accordingly, during the past few years, we have attempted to improve the surgical control of condyle and proximal segment position while using the sagittal split ramus osteotomy to advance the mandible. After several modifications, the device reported herein was used and the results evaluated in ten consecutive patients who underwent bilateral sagittal split ramus osteotomies with symmetric advancement of the mandible. This device enables the surgeon to obtain very precise reproduction of the "normal" proximal segment and condyle position at the time of surgery. The use of the device and documentation of its efficiency are presented.

Equipment Design↗