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D J Hauben

Publications and source records attributed to D J Hauben.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Treatment of velopharyngeal insufficiency--a 10 year experience].

Weak and hypernasal speech, along with nasal escape of air, are the main characteristics of velo-pharyngeal incompetence (VPI). We describe 10 years of experience (1989-1998) with surgical treatment of VPI. 51 patients underwent pharyngeal flap elevation. 37 had cleft palate (8 of them submucous), 7 had neuromuscular disorders and another 7 were idiopathic. All underwent evaluation by a speech therapist before and after operation. 25 had further nasal endoscopy and/or videofluroscopy. There was significant speech improvement in volume and clarity in 35 (73%), mild improvement in 13 (27%) and none in 3. The complication rate was 15% and included sleep apnea, wound infection and dehiscence, stridor and bleeding. Complications were correlated with advanced age. VPI should be diagnosed as early as possible to achieve good results and to prevent social problems.

Adolescent↗
PubMed1999

Synchronous appearance of keratoacanthomas in burn scar and skin graft donor site shortly after injury.

Skin malignancies can originate in burn scars (Marjolin's ulcer). The most common is squamous cell carcinoma, usually appearing years after injury. Split-thickness skin graft donor sites as a source of malignant transformation are far less frequent and demonstrate a shorter interval between surgery and tumor onset. Keratoacanthomas have rarely been reported to arise in such scars. We describe the simultaneous occurrence of keratoacanthomas on a spontaneously healed second-degree burn on the flank and in the scar of a skin graft donor site on the thigh, 4 months after a 40% total body surface area burn.

Burns↗
PubMed1999

Pharyngeal flap for velopharyngeal incompetence in patients with myotonic dystrophy.

Velopharyngeal incompetence (VPI) has been associated with neuromuscular disorders. Only 4 patients with myotonic dystrophy (MD) who underwent pharyngeal flap elevation for VPI have been reported in the literature. In 3 patients, surgery preceded the diagnosis of MD. Cardiorespiratory complications characterized the postoperative period of 3 patients. The authors present 3 patients with VPI and an established diagnosis of MD (by molecular genetics) who underwent pharyngeal flap elevation. The operation resulted in a major improvement in speech in all patients, although some relapse was noted later in 1 patient. Contrary to previous reports, none had peri- or postoperative cardiorespiratory complications. MD, although an uncommon etiology, should be considered in cases of late-onset VPI. Owing to differences between the authors' findings and previous reports, additional studies are needed before final conclusions can be reached regarding the benefit and safety of pharyngeal flap surgery in MD patients. At present, MD should not be considered a contraindication for this procedure, although close perioperative monitoring is indicated.

Adult↗
PubMed1999

[Malignant eccrine poroma--a rare occurrence].

Malignant eccrine poroma (MEP) is rare and both clinical and histologic diagnosis is often difficult. Therefore, diagnosis is sometimes delayed or even incorrect. We report a case in a 70-year old man with MEP of the leg. He demonstrated typical MEP behavior and the problems of differential diagnosis.

Acrospiroma↗
PubMed1998

Scorched eyelashes--do we treat them right?

Scorched eyelashes and burned eyelids are a common finding in facial burns, though the eye itself is often spared. Affected patients often complain of foreign body sensation and ocular discomfort in the absence of objective physical findings, other than scorched eyelashes and burned eyelash particles in the conjunctival sacs. This study was designed to evaluate the efficacy of prophylactic trimming of scorched eyelashes as a treatment for these findings and complaints. Eleven consecutive facial burn patients with bilateral eyelash scorching and no accompanying ocular damage were included. The eyelashes of one eye were trimmed, and those of the fellow eye served as untreated controls. Ophthalmic examinations were performed and eye-related complaints noted every other day for 10 days. We found that symptoms of foreign body sensation and discomfort occurred at a lower rate in the treated eyes (P<0.002) and no scorched eyelash particles were found in their conjunctival sacs (P<0.004) as compared to the untrimmed side. Conjunctival hyperemia was reduced. We suggest that shedding of scorched eyelash particles is a major cause of the ocular complaints in facial burn patients. Trimming the eyelash affords a simple and effective method of prophylactic treatment.

Conjunctiva↗
PubMed1998

Rubber foam and staples: do they secure skin grafts? A model analysis and proposal of pressure enhancement techniques.

The significance of even pressure application and protection against shearing forces using a tie-over dressing of skin grafts has been stressed previously. Several methods for pressure enhancement have been described with no quantification or comparison between the different techniques. Rubber foam and metal staples are commonly used for simple and quick application of the dressings. We developed a model for analyzing the contact interface of the dressing with the skin graft and the pressure exerted by it. A stapled rubber foam tie-over dressing was compared with the original silk thread tie-over dressing. Six different embodiments were also analyzed, all constructed using only rubber foam and metal staples. Imprint and maximal projection analyses of the undersurfaces were performed. The original silk thread tie-over dressing exerted a relatively low pressure but was uniformly distributed. A regular stapled tie-over dressing applied a ring-shaped pressure with minimal projection. Other methods are described providing different contact areas with the grafts and different pressures.

Bandages↗
PubMed1996

Elevation of eyeglasses from the nasal bridge--a simple solution.

Wearing eyeglasses following nose surgery is a problem faced by many patients who require glasses for clear vision. The solutions offered for this seemingly minor problem are unsatisfactory and usually mandate special spectacle frames. We developed a simple apparatus, using a baseball cap and a tie clip, that enables suspension of eyeglasses with no pressure on the nasal bridge. This solution utilizes readily available components and maintains clear vision with possible frequent readjustment of the glasses. It also avoids contact of the glasses with any part of the face, namely the operative site, dressing, and wound discharge. We find this technique a simple and useful solution for a disturbing problem in plastic surgery.

Aged↗
PubMed1996

Benign and malignant eccrine poroma--a flow cytometric comparison.

Eccrine poroma is a benign, slow growing, solitary adnexal tumor. Malignant degeneration may take place in longstanding solitary lesions; in such cases cutaneous and fatal visceral metastases have occurred. Our goal was to determine whether flow cytometry yields useful diagnostic and prognostic information on benign and malignant eccrine poroma. Flow cytometric analysis of the nuclear DNA ploidy pattern was performed on four samples of eccrine poroma and five samples of malignant eccrine poroma. All the histograms of the eccrine poromas were diploid. Two of five specimens (40%) of the eccrine porocarcinoma were aneuploid, and the other three (60%) were diploid. The diploid pattern represents another expression of the benignancy of eccrine poroma. Since abnormal DNA content is often correlated with tumor grade, the aneuploid DNA histogram of 40% of the patients with malignant eccrine poroma is not a surprising finding in this cytologically malignant neoplasm.

Acrospiroma↗
PubMed1996

Cutaneous malignant melanoma in young adults under age 30.

Epidemiologic and clinicopathologic features of malignant melanoma in 129 patients (44 males, 85 females) aged < or = 30 years between 1961 and 1992 were investigated. The number of new young melanoma patients (29 of 216 during the 1960's) declined to 52 of 676 during the 1980's. Predominant sites were legs among females, and head, neck and back among males. Nodular type lesions (56.6%) outnumbered superficial spreading tumors (38.8%). Thirty-one patients (24%) died of melanoma (median survival 2.9 years), with higher male mortality. A decrease in mortality rate was observed over the decades. The relationship between various parameters was analyzed. Nodular lesions were smaller and thicker than superficial spreading lesions, occurred more frequently in males, and carried a worse prognosis (34% mortality) than superficial spreading type tumors (14%); mortality rate was higher for thick (>4 mm) and for large tumor volumes (>300 mm3) vs. thin and small sized lesions, respectively (P = 0.000 for each). Average tumor thickness and volume declined throughout the last three decades. From the data obtained, a typical profile of a young melanoma patient is drawn.

Adolescent↗
PubMed1996

Female breast burns: conservative treatment with a reconstructive aim.

We retrospectively reviewed 421 burn patients treated in our burn unit in the past 3 years, focusing on breast burns in female patients. The aim of our study was to review the epidemiology, establish the mechanism of breast burn occurrence, and review the treatment plan. We evaluated 138 female burn patients, 38 (9%) of whom had non-isolated breast burns. In this group 25 burns (66%) were caused by scalds and 13 (34%) by fire. Scalds were responsible for first- to second-degree burns (50%), and cooking oil and fire for second- to third-degree burns (50%). A statistically significant difference was noted in the incidence of breast burns, which occurred mainly in late summer and fall (P = 0.03). There was a direct correlation between burn depth and duration of hospitalization, with average hospitalization time of 1.45 days for each percent of burn. Most breast burns were domestic, with children constituting the majority of the victims. Most breast burn patients were treated conservatively. Breast deformity on recovery varied in severity from minor deformity correctable with simple breast reduction surgery in older patients to severe deformity requiring further reconstructive surgery in infants.

Adolescent↗
PubMed1995

[Epidemiology and prognostic factors in cutaneous malignant melanoma].

207 patients with primary cutaneous malignant melanoma were admitted between August 1, 1988 and July 31, 1992 for local excision and treatment. The female to male ratio was 1.4:1 and the peak age was in the seventies. The most frequent site in males was the back and in females the legs. Superficial spreading melanoma was the most frequent type (40%); there was also a high rate of nodular melanoma (20%), particularly in males. Thin melanomas accounted for most of the cases. On follow-up 27 (13%) developed metastases in transit or in regional lymph nodes and 10 (5%) developed distant metastases; 2 (1%) had locally recurrent melanoma and 2 died of metastatic melanoma. There was a significant positive correlation between Breslow thickness, Clark's level of invasion, histopathological ulceration, nodular and acral lentiginous type of lesion and development of metastases. These data may be valuable for public and professional education and in the prediction of outcome of melanoma.

Aged↗
PubMed1995

Malignant fibrous histiocytoma of the breast.

Primary malignant fibrous histiocytoma of the female breast (MFH) occurs very rarely, and only 22 cases have been reported so far. We describe a 42-year-old female in whom MFH of the breast was diagnosed, and review the available literature. In accordance with knowledge concerning the biological and clinical behaviour of breast MFH, either wide local excision or mastectomy combined with axillary lymph nodes dissection is recommended, due to the high rate of recurrence and metastatic potential of this tumour.

Adult↗