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Biomedical subjects

F J Stucker

Publications and source records attributed to F J Stucker.

At least 55 records · Page 3Linked to original sources
PubMed1993

Rhinophyma: a new approach to hemostasis.

Rhinophyma is a benign tumor of the nose. It possesses both functional and cosmetic implications. The pathophysiology of the disease is reviewed to illustrate the basis for the treatment options. Many different therapeutic modalities have been reported in the literature, each with reasonable success. A new treatment approach to this condition is developed using a combination of the Weck blade and the argon beam coagulator. This modality is found to be relatively simple and less traumatic than all the other techniques used by the senior author.

Aged↗
PubMed1992

An approach to management of keloids.

Keloids present a major therapeutic dilemma for the surgeon because of frequent recurrences. We use a new protocol for management of large primary or recalcitrant keloids. The technique employs carbon dioxide laser resection of the keloid and then allows the open wound bed to heal by secondary intention. The open wound is treated as though it were a third-degree skin burn. The wounds invariably orient their long axis parallel to the relaxed skin tension lines. No keloid has ever been noted to recur before epithelial migration is complete. Careful follow-up detects early recurrences that are then treated with injection consisting of 40 mg/mL of triamcinolone acetonide (Kenalog), 150 mg of hyaluronidase (Wydase), and 2% lidocaine via a dermajet. Thirty-seven patients were treated with this protocol and have been followed up for at least 2 years. A control rate of 84% has been achieved with compliant patients.

Adult↗
PubMed1992

The perichondrial cutaneous graft. A 12-year clinical experience.

The perichondrial cutaneous graft is a reliable and versatile composite graft that possesses unique properties for reconstructive surgery. The graft consists of epidermis, dermis, scant subcutaneous tissue, and the perichondrial layer. Our clinical experience completely mirrors our findings from animal studies. A clinical study of 112 perichondrial cutaneous grafts includes patients whose ages ranged from 7 days to 92 years. The various clinical applications for use of the perichondrial cutaneous graft include repair of auricular deficits, ectropion, certain facial defects, and a variety of nasal reconstructive situations. A review of our clinical experience demonstrates excellent cosmesis and no contraction of any of the graft. The graft is routinely harvested from the anterior conchal bowl, and the donor defect is closed after cartilage resection with a postauricular interpolated skin island ("flip-flop flap"). Numerous situations present many options for reconstructive surgery. The perichondrial cutaneous graft provides such an alternative, offering great reliability and superb cosmesis.

Adolescent↗
PubMed1991

Revision meatoplasty: management emphasizing de-epithelialized postauricular flaps.

Revision meatoplasty represents a unique reconstructive dilemma to the otolaryngologist. Often, the external canal and conchal skin are or have been involved in an inflammatory process and subsequent scarring that compromises or precludes its use in a reconstructive procedure. Our technique recommends one or more tongues of postauricular normal vascularized skin flaps be developed and rotated into the ear canal. The portion lying beneath the auricle is de-epithelialized as it is tunnelled under the conchal bowl. This random postauricular flap permits the introduction of healthy skin at the flap's tip for resurfacing the canal and meatus. Because the flap is introduced from a posterior direction, the inevitable scarring and forces of contraction serve to keep the meatus patent. This is marked contrast to usual repair attempts that introduce coverage at the meatus with a skin graft, which subsequently heals, with a circumferential scar compounding the stenosis. The exact design of the flap is generally determined by the presence or absence of previous postauricular healed scar. There is most often a previous postauricular incision from ear surgery that dictates the exact design of the flap or flaps. Superiorly and/or inferiorly based flaps have been used successfully. The segment that lies beneath the auricle is de-epithelialized using the CO2 laser. This greatly facilitates the speed and precision of the de-epithelializing maneuver. To date, 32 cases of conchal and external canal stenosis have been successfully managed using this technique. The indications, technical description, and representative examples are the basis of this manuscript, which offers the otolaryngologist a viable option in revision meatoplasty.

Adolescent↗
PubMed1990

Management of animal and human bites in the head and neck.

Management of bites requires both local wound and systemic considerations. The authors will highlight their experience in 32 cases. Interestingly in this series, human bites were more common than animal bites. The bacteriology, antimicrobial therapy, and surgical treatment of human and animal bites will be reviewed. A management protocol that we use is based on whether the bite was inflicted by a human, dog, or other animal. The discussion will include cases demonstrating immediate and delayed reconstruction. Long-term follow-up was possible for a number of these patients.

Adolescent↗
PubMed1988

Reduction cheiloplasty. An adjunctive procedure in the black rhinoplasty patient.

The reduction cheiloplasty is a simple surgical procedure that can easily be used adjunctively with a black patient who is undergoing rhinoplasty. Its acceptance by patients and surgeons is increasing, but his useful procedure continues to be underutilized. This article urges the incorporation of the reduction cheiloplasty in the armamentarium of those who routinely perform rhinoplasties on black patients. It is a relatively minor procedure that is easily reproducible and yields excellent, predictable results with few complications. The technique, pitfalls, and morbidity are outlined in this article. The improvement achieved in facial harmony by the addition of this procedure makes it a surgical bargain.

Black People↗
PubMed1988

Frontal sinus fractures: some problems and some solutions.

Head trauma can result in serious injuries leading to life-threatening situations. Often accompanying these injuries are fractures involving the frontal sinus. Some fractures are subtle and difficult to diagnose, while others are massive and difficult to treat. The experience at this institution in the management of frontal sinus fractures is examined. Particular emphasis is placed on the problematic cases. These include fractures that were nearly overlooked, those that were associated with massive CSF leaks, and those which were extensively comminuted. In treating some of the most severe compound injuries, a frontalis myofascial flap has been used successfully to "plug" the site of CSF leakage. The review will include the types of fractures encountered, associated injuries, errors in diagnosis, the treatment rendered, and the complications which resulted. As encountered in other studies relating to trauma, adequate follow-up has been a serious shortcoming. The protocol presently used in the management of these injuries will be outlined.

Adolescent↗
PubMed1987

Squamous cell carcinoma of the external ear: a review of 75 cases.

Squamous cell carcinoma of the external ear can be a potentially lethal lesion. Although it is the most common cancer involving the pinna, the variables that have the greatest impact on prognosis are still in question. We reviewed 75 cases of squamous cell carcinoma of the external ear to determine patterns of occurrence and treatment failure. Forty patients had adequate follow-up for determination of cancer control rates. Local control was successful with initial treatment in 85% of the cases. The incidence of lymph node metastases was 10%, whereas distant metastasis occurred in only one patient (2.5%). This series differs from others in that most patients were unselected and most of the lesions treated were early (less than 1 cm). The significance of positive margins after surgical excision is also analyzed.

Aged↗
PubMed1987

Non-caucasian rhinoplasty and adjunctive reduction cheiloplasty.

This article is based on 19 years of experience that includes more than 300 cases of reconstructive nasal surgery in non-Caucasians. The evolution of the author's surgical technique is presented, as influenced by long-term effects of various surgical maneuvers. The adjunctive reduction cheiloplasty is also discussed.

Black People↗
PubMed1985

Management of perforations of the hypopharynx and cervical esophagus.

Complications related to perforations of the upper aerodigestive system carry a 15% mortality. Nine cases of intraluminal injuries to the hypopharynx and cervical esophagus are reviewed. Seven were related to iatrogenic causes and two associated with foreign bodies. This study details the cause and location of the injuries, associated signs and symptoms, and the resultant morbidity. A protocol for the management of suspected perforations is outlined.

Adult↗
PubMed1985

The method and management of thyroid surgery in the pediatric patient.

Thyroid surgery in the pediatric age patient accounts for a small minority of all thyroid surgery. Batsakis and Nishiyama reported only 136 patients under the age of 18 who underwent thyroid surgery in 27 years at the University of Michigan. In most series involving the pediatric age group, the majority of thyroid procedures are performed on adolescents. Thyroid surgery in the young child requires special precautions in addition to those routinely associated with thyroidectomy in the adult. The techniques and perioperative management of the pediatric thyroidectomy employed at our institution has evolved as experience is gained. Our experience with five such patients with adequate follow-up will be presented.

Adenoma↗
PubMed1984

Management of nasal trauma in children.

The management of nasal trauma in children differs considerably from that in adults. In children, the evaluation is decidedly more difficult because of lack of patient cooperation and different anatomical features. The controversy regarding surgical manipulation of the pediatric nose has resulted in confusion as to the proper management of nasal trauma in this age group. On the basis of our experience with these problems, we have developed a philosophy of management; its principles and techniques are described herein.

Adolescent↗