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H P Howaldt

Publications and source records attributed to H P Howaldt.

At least 37 records · Page 2Linked to original sources
PubMed1995

Three years of experience with the free vastus lateralis flap: an analysis of 30 consecutive reconstructions in maxillofacial surgery.

Free vastus lateralis flaps for maxillofacial reconstruction were used in 30 patients. On the basis of its anatomy, this flap can be inserted as a musculocutaneous or musculofascial transplant in slim or normal-weight patients if extensive defects exist. The microvascular transfer is facilitated and accelerated by the long and high-caliber vascular pedicle and flap raising, which can be performed at the same time as tumor resection. We see indications for the musculocutaneous transplant in almost all sections of the oral cavity, particularly for tongue reconstruction; the vastus lateralis flap can be inserted in a purely muscular form for defect coverage on the scalp in connection with split skin. The donor defect is minimal functionally and aesthetically, and the success rate is approximately 90% for all flap transfers.

Adult↗
PubMed1994

Transnasal approach to the orbit, the interorbital space, and the nasopharynx.

We present a surgical procedure that provides exposure to the medial part of the orbit, the interorbital space, and the nasopharynx. A midline incision of the nose is followed by a pedicled osteotomy of the lateral nasal wall and the medial wall of the orbit in one piece. This transnasal approach provides good exposure to the medial parts of the craniofacial junction to remove foreign bodies or benign tumors.

Angiofibroma↗
PubMed1994

[Orbital reconstruction with tabula externa for correction of post-traumatic enophthalmos].

In general the posttraumatic enophthalmos results from an enlargement of the orbit mainly in its dorsal part. The surgical correction must be performed in this particular part and calvarian bone grafts are very suitable for the procedure. In 20 patients the aesthetic appearance could significantly be approved. Anyhow functional aspects, mainly the binocular vision, must not be neglected.

Bone Transplantation↗
PubMed1994

[High caloric parenteral nutrition in patients with mouth and oropharyngeal cancers--a clinical study].

Patients with carcinomas of the oral cavity and oropharynx often show signs of malnutrition. This is caused by reduced intake in patients due to chronic alcoholism resulting in suppressed appetite and disturbed gastrointestinal functions. Also the growth of the tumor can cause painful swallowing. The effects of chronic malnutrition reduce patients tolerance regarding surgical treatment, chemotherapy and radiation. A pretherapeutic parenteral balanced nutrition should achieve an anabolic metabolism. Changes in body cell mass (bcm) as a parameter of total protein synthesis can be estimated by bioelectrical impedance analysis in order to prove the success of this management. Twenty-eight patients participated in this study, divided into three groups: group 1 = 18 male subjects and group 3 = 3 female subjects, all able to be operated upon, and group 2 = 7 male subjects, not able to be operated. High caloric nutrition in group 1 lead to a higher increase of bcm than in group 2. The review of single cases showed that in both groups one part of the patients failed increasing bcm despite nutrition. The therapeutic response was correlated to survival by means of a Kaplan-Meier analysis and a Cox-model. Survival probability could positively be correlated to an increased bcm.

Adult↗
PubMed1993

A comparison of radical and conservative neck dissection.

A review is presented of the confusing terminology applied to the various types of neck dissection. It is recommended that the terms "conservative" and "radical" be based on clear definitions. The fourth prospective, randomized DOSAK therapy study deals with the controversial issue of radical as compared with conservative neck dissection. Patients with squamous cell carcinoma (SCC) of the oral cavity who had not been treated before were randomized and stratified according to the DOSAK treatment-dependent prognostic index (TPI). At present, 104 patients have been evaluated, of whom 48 had radical neck dissection, and 56 conservative neck dissection. Tumor location and patient age and sex are equally divided in both therapy groups. After an average follow-up time of 460 days, the relative mortality for both therapy groups is 23%. At this stage, there is no difference between the two groups in the percentage of patients with complete remission or in the percentage of patients alive. At this stage, there appears to be no difference between the two groups with regard to patient survival or recurrent disease.

Carcinoma, Squamous Cell↗
PubMed1993

Proposal for a modified T-classification for oral cancer. The DOSAK.

The UICC plans to publish a modification of the TNM system. A proposal for a T category is calculated out of the data from the DOSAK tumour registry containing more than 3000 cases of primary squamous cell carcinomas of the oral cavity & oropharynx. By adding tumour thickness as a factor of the T component, the prognostic relevance of the classification is enhanced.

Carcinoma, Squamous Cell↗
PubMed1993

A novel technetium-99m labeled monoclonal antibody (174H.64) for staging head and neck cancer by immuno-SPECT.

A novel murine monoclonal antibody (MAb 174H.64) was labeled with 99mTc by a direct method. MAb 174H.64 detects a cytokeratin-associated antigen which is expressed by over 90% of all squamous cell carcinomas. Panendoscopy, sonography and computerized tomography scan were performed in all cases as well as magnetic resonance imaging (in selected patients). Pre-operative immunoscintigraphy was performed in 21 patients with histologically proven primary carcinomas (18 with remaining primary tumors and 3 with lymph node recurrences). Scintigraphic images were obtained 4-6 h after injection of 1.1 GBq of the 99mTc-labeled antibody (2 mg). Late images were acquired 18 to 24 h after injection. Single-Photon-Emission-Computed Tomography (SPECT) of the head and thorax was performed in all patients. The primary tumors were immunoscintigraphically visualized in all 18 patients with remaining primary tumor. Fifteen of 18 loco-regional lymph node metastases were visualized by immunoscintigraphy (the smallest lesions had a diameter of < 1 cm), in one patient lymph node metastases were detected by immunoscan only. Two metastatically involved lymph nodes were identified by histology only (micrometastases). Distant metastases were present in 3 patients, of which two were identified by immunoscintigraphy. Immuno-SPECT according to this method was a sensitive and specific imaging modality for preoperative staging of patients with squamous cell carcinoma of the head and neck and detected lymph node metastases with higher accuracy than conventional clinical and imaging modalities.

Animals↗
PubMed1992

[Fiberoptic intubation as a safe method for the treatment of odontogenic abscesses].

Infections caused by dental disease may result in severe swelling of the throat and whole neck. In an operation for opening an abscess, the initial phase of general anaesthesia is often critical due to obstructions of the airway and trismus. Therefore the wide use of a fibre-optic intubation is advocated in order to avoid an emergency tracheostomy or other complications.

Airway Obstruction↗
PubMed1991

Experiences in surgical repair of a totally avulsed scalp.

A case of total scalp avulsion is described in surgical detail. The neurovascular bundles remained nearly untouched on the surface of the galea aponeurotica. Only one frontal branch of the left temporal artery was found to serve as a nutrient vessel for the whole scalp. Three veins around the scalp circumference supplied the venous drainage. The right-dorsal part of the scalp underwent necrosis, obviously because of internal disruption on the capillary level. This area had to be skin-grafted secondarily. Mechanical aspects in respect of the neuro-vascular situation are discussed theoretically and some advice on the surgical approach is derived from our experience.

Adolescent↗