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Biomedical subjects

B Speculand

Publications and source records attributed to B Speculand.

At least 19 recordsLinked to original sources
PubMed2000

Total prosthetic replacement of the TMJ: experience with two systems 1988-1997.

We report our experience with the Vitek VK II and the Christensen systems for total prosthetic replacement of the temporomandibular joint, in 62 patients treated between 1988 and 1997. Thirteen were treated in Birmingham and 49 in Gloucester. A total of 86 joints were replaced, of which 27 (31%) were Vitek VK II and 59 (69%) were Christensen prostheses. Just over half of the patients were treated for degenerative arthropathy or osteoarthritis, and the second most common diagnosis was rheumatoid arthritis. Twenty-five patients had had previous operations. The median follow-up was 14.5 months (range 1-120). Preoperatively only 14 patients (23%) could eat all types of food - and postoperatively this increased to 48 (77%). Thirty-nine patients (63%) reported severe pain preoperatively compared with three (5%) postoperatively. No prostheses were rejected, but four patients required replacement of Vitek VK II by Christensen prostheses; all four showed histological evidence of a foreign body giant cell reaction. The overall success rate was 58/62 patients and 81/86 joints replaced (94% in each case). However, for the Vitek VK II system alone the success rate was 14/17 patients (82%) and 24/27 joints replaced (89%).

Adult↗
PubMed1999

Does diplopia persist after blow-out fractures of the orbital floor in children?

Blow-out fractures of the orbital floor are comparatively rare in children, particularly those less than 8 years old. Published reports have suggested that the long-term outcome in children is worse than that in adults with similar injuries. In this study, we examine this question in the light of data from 45 children from Birmingham and Glasgow who were divided into three age ranges: 0-9 years (n = 9), 10-12 years (n = 11) and 13-15 years (n = 25). Fourteen were treated conservatively and 31 were treated surgically. The 0-9-year-old group were more likely to have small- or medium-sized defects in the anterior part of the orbital floor, which were of a linear 'trapdoor' type. The 13-15-year-olds tended to have larger 'open-door' defects. More than half the 0-9-year-olds had persistent diplopia compared with just under a third of the two other age groups. This diplopia took twice as long to resolve in the younger group compared with the other two groups. Our results confirm the view that younger patients have more persistent problems than adults after blow-out fractures of the orbital floor.

Adolescent↗
PubMed1997

Sjögren's syndrome in women presenting with chronic dyspareunia.

OBJECTIVE: To identify cases of Sjögren's syndrome among women with chronic dyspareunia who did not already have a diagnosed rheumatological disorder. DESIGN: Prospective recruitment over 12 months. SETTING: Tertiary referral service for the assessment of vulval disease. PARTICIPANTS: Women with chronic dyspareunia who had musculoskeletal symptoms, Raynaud's phenomenon or symptoms of ocular or oral dryness. METHODS: The women underwent a Schirmer tear test and a comprehensive auto-antibody screen including latex fixation test for rheumatoid factor, antinuclear, anti-Ro, anti-La and anti-salivary duct antibodies. A labial salivary gland biopsy and vaginal biopsy were taken for routine histological analysis. MAIN OUTCOME MEASURES: Cases of definite and probable Sjögren's syndrome were identified using the European criteria. RESULTS: Eleven women were assessed for features of Sjögren's syndrome. Four had definite primary Sjögren's syndrome, two had probable primary Sjögren's syndrome and one had probable secondary Sjögren's syndrome. Among these seven women the median duration of vaginal symptoms was seven years (range 0.25-20), of ocular symptoms was one year (range 0.25-2) and of oral symptoms was 1.5 years (range 0-6). In all but one woman dyspareunia presented before ocular or oral symptoms, often by many years. CONCLUSIONS: Although well-recognised as a feature of established Sjögren's syndrome, this study emphasises that chronic dyspareunia can be a presenting feature in these women, antedating the emergence of ocular or oral symptoms by many years. Symptoms of ocular or oral dryness, Raynaud's phenomenon or musculoskeletal symptoms should be sought in women with chronic dyspareunia to identify those who merit further investigation.

Adult↗
PubMed1996

3D computer data capture and imaging applied to the face and jaws.

There have been few attempts in the past at 3D computer modelling of facial deformity because of the difficulties with generating accurate three-dimensional data and subsequent image regeneration and manipulation. We report the application of computer aided engineering techniques to the study of jaw deformity. The construction of a 3D image of the mandible using a Ferranti co-ordinate measuring machine for data capture and the 'DUCT5' surface modelling programme for image regeneration is described. The potential application of this work will be discussed.

Analog-Digital Conversion↗
PubMed1993

Mycobacterial infection of the parotid gland: an unusual cause of parotid swelling.

Six cases of mycobacterial infection of the parotid gland are reviewed. All six cases presented solely with a slowly enlarging parotid swelling clinically indistinguishable from a parotid tumour. All of the swellings required surgical removal, superficial parotidectomy in four cases, and enucleation in two cases to obtain a definitive diagnosis.

Adult↗
PubMed1992

Optical disguising of orbital deformity with prism and cylinder lenses.

This paper describes the way in which prism and cylinder lenses may be used to disguise orbital dystopia when the affected eye is blind. The lenses used can correct the height of the eye, the opening of the eyelids or the rotation or slant of the eye. Four cases are presented to illustrated this technique, which may be used either instead of, or as an adjunct to orbital surgery. An investigation of these effects is described using a mannikin head fitted with an optician's trial frame, with measuring by the reflex metrograph. This revealed that an inferiorly displaced eye may be elevated by 4 to 5 mm, that the vertical eyelid opening may be widened (or narrowed) by just under 20% and that an adverse slant of the eye may be rotated in either direction by about 4 degrees.

Adolescent↗
PubMed1992

The origin of the temporalis muscle flap.

This paper explores the origin of the temporalis muscle flap which has been attributed to Golovine, a Moscow ophthalmic surgeon, who described a forehead skin transposition flap. Small temporalis muscle transpositions were used in surgery for TMJ ankylosis, but the use of the majority of the muscle for reconstruction of facial defects was first described by Sir Harold Gillies during the 1914-18 war.

History, 19th Century↗
PubMed1991

Ultrasonography as a diagnostic aid in temporomandibular joint dysfunction. A preliminary investigation.

Twenty-five patients presenting with temporomandibular joint dysfunction were examined by both ultrasonography and arthrotomography. Ultrasonography produced an image of the TMJ which was at right angles to the image produced by arthrotomography, since the ultrasound picture was in the coronal plane; with ultrasonography the meniscus became more visible during mouth opening. Anterior displacement of the meniscus was associated with deeper location of the condylar head within the glenoid fossa whilst a perforated meniscus produced a bilobed image. This study has provided a preliminary look at ultrasonography of the TMJ and has shown promise for further work. The present images are not ideal for clinical use but they show the possible potential for non-invasive diagnosis which might be provided by higher resolution ultrasound equipment than that used in this study.

Adolescent↗
PubMed1990

Multiple idiopathic external resorption of teeth.

Three cases of multiple idiopathic external resorption are presented. The condition is characterised by the absence of any widespread inflammatory response both in the gingival tissues and within the dental pulp. The only curative treatment is exodontia.

Adult↗
PubMed1989

Synovial fluid glycosaminoglycan (acid mucopolysaccharide) analysis in assessment of temporomandibular joint dysfunction. A pilot study.

Temporomandibular joint (TMJ) synovial fluid was aspirated from normal control subjects and patients undergoing surgery for TMJ dysfunction. The glycosaminoglycan (GAG) composition of this fluid was analysed and compared with the clinical diagnosis and histological appearance of the condylar tissues. Changes in GAG composition were observed where a histologically hyperplastic response was seen in joint tissues, but these findings did not necessarily correlate with the initial clinical diagnosis. It is suggested that the fluid composition reflects the current metabolic activities of the tissues and may provide a useful marker of such processes.

Adult↗
PubMed1988

Three-dimensional measurement: the accuracy and precision of the reflex metrograph.

The Reflex Metrograph is an optical plotter which is linked directly to a microcomputer and allows direct three-dimensional measurements of irregular shaped objects up to 300 mm maximum dimension without contacting the object. This study shows that it is possible to generate reproducible results with an operator measurement error of less than 0.2 mm for linear distances on objects up to 200 mm maximum dimension. The Reflex Metrograph tends to undermeasure by 0.67% or by up to 2.00 mm per 300 mm and is very slightly less accurate in the vertical plane. The potential use of this measuring instrument is discussed.

Cephalometry↗
PubMed1988

Three-dimensional measurement: the accuracy and precision of the Reflex Microscope.

The Reflex Microscope is an optical plotter which is linked directly to a microcomputer and allows direct three-dimensional measurements of irregular shaped objects up to 100 mm maximum dimension. This study shows that it is possible to generate reproducible results with an operator measurement error of less than 0.15 mm for linear distances. The Reflex Microscope tends to undermeasure by 0.28% or by up to 0.14 mm per 50 mm. There was no detectable difference in accuracy between the three planes X, Y and Z. In planes X and Y the two-dimensional accuracy at high magnification of a 1.000 mm scale was 1.004 mm in X and 1.008 mm in Y planes.

Computer Systems↗