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Biomedical subjects

B Spiessl

Publications and source records attributed to B Spiessl.

At least 37 records · Page 2Linked to original sources
PubMed1980

A new method of anatomical reconstruction of extensive defects of the mandible with autogenous cancellous bone.

The mandible and adjacent area is a frequent site of various primary malignant tumours. Therefore resection of this bone is quite often indicated. The main problems associated with defects of the mandible resulting from extensive tumour surgery are: 1. the disadvantage of intermaxillary fixation for immobilization of the stumps of the mandible; 2. the risk of infection; 3. rigid fixation of the stumps of the mandible plus transplant; 4. the different shapes of those regions that have to be replaced (e.g. angle or chin); 5. the poor conditions for revascularisation of the transplant expecially after combined therapy (surgery and radiation). In order to find a way to solve these problems we have developed the three-dimensionally bendable defect bridging plate (3-DBDB plate). Further more we have developed a special technique for the transplantation of compressed cancellous bone. In the first part of the paper the 3-DBDB plate and the principles of transplanting compressed cancellous bone, as well as the specially developed instruments are explained. The second part deals with a typical case and problems of infection.

Aged↗
PubMed1980

[Fractures of the jugal bone -- signs, therapy and late sequelae (A study on 141 cases treated on the basis of a uniform concept) (author's transl)].

The article discusses the signs and treatment of fractures of the jugal bone. Basing on 141 patients treated in our clinic, a detailed analysis is given of the problems connected with post-traumatic sinusitis maxillaris, as well as the neurological late sequelae of the n. infraorbitalis. Accurate repositioning and fixation of the fragments are essential; the authors give preference to wire suture. No routine revision of the maxillary sinus and decompression of the nerve are necessary.

Fracture Fixation, Internal↗
PubMed1979

Ameloblastic fibroma and its sarcomatous transformation.

A case of ameloblastic fibroma, and one of its more aggressive variety, the ameloblastic "fibrosarcoma", are presented. The clinical and morphologic differences are discussed. In our opinion, ameloblastic "fibrosarcoma" is a semimalignant tumor. Therefore we propose "proliferating ameloblastic fibroma" as a more appropriate designation.

Adolescent↗
PubMed1979

[Case reports of differential diagnosis of facial neuralgia caused by extracranial neoplastic processes].

Neoplastic extracranial processes may be central or peripheral. Peripheral pains appear often late and cancerous progress may therefore be overlooked. Central (cranio-vertebral space) pains may be located in the mandible, supra- and infraorbitally, glossopalatally, lingually and in the maxilla. They may be localized or projected and mostly accompanied by paresthesias and hyperesthesias. It is important to make a differential diagnosis with a cerebral tumor which causes cephalic rather than facial pain.

Diagnosis, Differential↗
PubMed1979

[Plastic bolting device for the temporomandibular joint for treatment of hypermobility (Re-examination results of the first 28 cases)].

Hypermobility of the mandibular condyle may only slightly be influenced by conservative treatment. On the other hand, all surgical methods, except the one described here include a risk factor concerning nerve or blood vessel damage. The present method limits, by plastic surgery, the joint mobility. 28 such operations were checked for results. The cases with recidivating luxation with trismus and blocking of the mandible reacted very favourably. The cases with habitual subluxation without trismus, and the cases with myofacial pain syndrome were not as favorable, objectively seen. Subjectively, however, the patients feel the operation is a success. Further investigation by control checking on late results is indicated.

Adolescent↗
PubMed1979

[Transposition osteotomy of the upper jaws and immobilization with cranial fixation devices].

Retrognathia in a patient who has undergone surgery for correction of a cleft palate constitutes a specific indication for transposition osteotomy of the upper jaw. A satisfactory operative technique is described in which as much as possible of the posterior part of the hard palate is retained. The operation is followed by immobilization of the upper jaw with a halo. The results of follow-up examination of 9 patients who had been operated on between 1975 and mid-1977 are described in detail. They revealed a pronounced tendency to postoperative recurrence of the deformity and showed the importance of postoperative retention in preventing recurrence. The topics discussed also include the timing of the operation, of the postoperative retention, the fitting of dentures, and of subsequent plastic surgery.

Adult↗
PubMed1979

[Brain abscess after odontogenic infection].

Dentogenous infections are among the most frequent in the maxillo-facial area. Case report of a dentogenous-pyogenous-actinomycotic mixed infection, with the complication of a secondary brain abcess is given. Consecutively, the patient became an invalid. Origin and pathogenesis of the disease are described. Also, liberal incision and drainage as a preventive measure are recommended.

Actinomycosis↗
PubMed1978

[Methodological problems on the preparation and realization of multicientric field studies on mouth and salivary gland neoplasms].

The objectives of multicentric field trials are to provide a base for future revisions of the TNM system in order to ameliorate the existing classifications or to create new ones. The data are collected in a prospective and standardized manner and their evaluation is centralized. Therapy and follow-up in each case are registered at regular intervals and individual treatment is reported according to a standardized and flexible procedure. The particular methodological problem lies in the necessity of aligning the volume and quality of the desired information with the practicability of data collection.

Follow-Up Studies↗
PubMed1978

[Injuries of the maxillofacial region (author's transl)].

The essence of the Basle study on city traffic accidents is a 60% decrease of head injuries following the increase of car occupants wearing seat belts. The Heidelberg study shows similar results. The frequency of facial and cervical soft tissue injuries is 27% with 114 belt wearers and 71% with 1250 car occupants not wearing seat belts. The pattern of lacerations caused by the windshield is discussed. Duly fixed seat belts offer a real chance of survival and only minor injuries at a collision speed of 70 km/h.

Accidents, Traffic↗
PubMed1978

[Principles of the TNM system].

The principle of the TNM system consists of the exclusive description of the anatomical spreading of cancerous diseases. We distinguish between clinical and postsurgical classification. Clinical classification is applied in principle before the decision for therapy. This pretherapeutical status is the foundation for the interdisciplinary treatment planning, prognosis and recording of results. The postsurgical classification is mainly used in visceral localizations. According to the most important stages of the disease, further classifications may be used, like the surgical-evaluative and the autopsy classification. Such different classifications are necessary because the preciseness of the prognosis depends upon the accuracy of the description of tumor extension. It is therefore important to supplement the tumor formula by a factor C (C for Certainty). This factor indicates by what diagnostic means the TNM categories of the mentioned formula were determined. The C-factor categories are defined and described in their principal use. Finally there are some fundamental observations to the problem of the revision of the TNM classification.

Humans↗
PubMed1976

[Functionally stable osteosynthesis of the mandible by means of an excentric-dynamic compression plate. Results of a follow-up of 25 cases].

The stability of internal fixation is enhanced by axial compression on the fracture ends. If internal fixation of the mandible is achieved by a compression plate at the lower border of the mandible (compression side), distraction of the fracture ends on the occlusal side occurs which has to be counteracted without damaging the roots of the teeth on the occlusal side (traction side) or without damaging the inferior alveolar nerve. From experiments on models it was seen that an acceptable solution to this problem is given by the use of the combined compression plate and tension band plate or the "Excentric Dynamic Compression Plate" (EDCP). In this paper 25 clinical cases of internal fixation of the mandible by means of the EDCP are examined and discussed. The following relevant facts were reviewed on all patients: -- kind of trauma -- age -- dentition -- localization of the fracture -- local and general additional injuries -- time of operation -- material used for internal fixation -- type of occlusal immobilisation during operation -- use of antibiotics -- skin closure -- mobilisation -- hospital stay -- duration of work disability -- complications -- scarring -- neurological disablement -- malocclusion In this paper emphasis is layed upon internal fixation by means of the EDCP. The clinical evaluation of the 25 cases clearly demonstrates that the main indication for internal fixation with the EDCP is given in fractures of the horizontal ramus of the mandible, because in this localisation the plate has to be applied beneath the inferior alveolar nerve. A further indication for internal fixation with the EDCP are fractures of the angle of the mandible. In these cases the tension band principle by means of a tension banc archbar or a tension band plate cannot be applied, because of missing teeth on the proximal fragment, or a non erupted wisdom tooth. These indications can be summarized as follows: -- In fractures of the angle of the mandible--when ever possible compression plate and tension band plate, otherwise EDCP -- In fractures of the horizontal ramus--EDCP -- In fractures of the mandibular front--DCP.

Bone Plates↗