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Biomedical subjects

J Lilja

Publications and source records attributed to J Lilja.

At least 55 records · Page 3Linked to original sources

The step technique for the reconstruction of lower lip defects after cancer resection. A follow-up study of 165 cases.

One hundred and sixty-five patients with localized cancer of the lower lip were excised and reconstructed over a 25-year period using Bengt Johanson's step technique. Eight-eight percent of the tumors were less than 2 cm in size and 65% were of high histopathological differentiation. Fifty-six percent were reconstructed with bilateral step flaps. Nine local recurrences appeared in 5 patients, none of whom died of lip cancer. Eight patients later developed regional metastases and 3 of these patients died of lip cancer. The 5-year survival rate was 98%. The step technique is recommended for reconstruction of lip defects of up to 2/3 of the lower lip and may, in larger resections, be combined with either a fan flap or an Estlander flap. The outstanding functional results are due to the use of adjacent tissue for the reconstruction which preserves the normal arrangement of muscles, vessels and nerves.

Adult↗

The nationalization of the Swedish pharmacies.

The first Swedish parliamentary bill suggesting government-owned pharmacies was introduced in 1907 and was rejected. A number of official proposals were put forward until 1970 when the government decided to nationalize the Swedish pharmacies. The process leading to nationalization was influenced by background and by more specific 'release' factors operating in the 1960s. The opposition in parliament to nationalization was only minor. The new organization formed, Apoteksbolaget AB, was given a drug selling monopoly and was organized as a limited company regulated by an agreement between the government and Apoteksbolaget.

History, 19th Century↗

Orthognathic surgery with no postoperative intermaxillary fixation.

In 113 patients orthognathic surgery was performed. Both maxillary, mandibular and combined procedures were used. Intermaxillary fixation was avoided in all cases. It was found that the procedures presented offer a safe correction of the jaw with minimal complications during surgery and in the postoperative period. Preliminary data suggest that the stability of the segment is in good accordance with procedures with intermaxillar fixation.

Adolescent↗

Facial morphology and occlusion at the stage of early mixed dentition in cleft lip and palate patients treated with delayed closure of the hard palate.

Cephalometric radiographs and dental study casts were analyzed in a group of 23 seven-year-old cleft lip and palate patients, 16 with unilateral and 7 with bilateral cleft. The patients' primary surgical procedures had been completed except for closure of the cleft in the hard palate. For comparison, similar records from another group of patients, 18 with unilateral and 8 with bilateral cleft lip and palate, were studied. In these cases the cleft of the hard palate had been repaired in infancy, using a vomer flap procedure. The results indicated that midfacial growth and dental occlusion of the unilateral cleft sample was significantly better in patients whose closure of the hard palatal cleft had been delayed to the stage of mixed dentition than where repair had been performed with a vomer flap in infancy. No differences were found, however, between similar subgroups with bilateral cleft lip and palate.

Cephalometry↗

Bone grafting at the stage of mixed dentition in cleft lip and palate patients.

Our results of bone grafting to the alveolar process during the mixed dentition were investigated in 55 consecutively treated patients (66 clefts). The amount of remaining bone and gingival retraction at the tooth mesial to the cleft after 3 and 12 months was measured and correlated with the following anatomical conditions present during surgery: width of the cleft, rotation of the adjacent incisor, stage of eruption of the tooth distal to the cleft. It was also considered if any deciduous lateral incisor or canine was extracted during surgery and if any flap dehiscence took place postoperatively. It was found that flap dehiscence resulted in significantly less bone at 3 months and at 1 year after surgery. Furthermore, extraction of a deciduous tooth was found to be significantly correlated to less bone 1 year after surgery, in which cases there were also persisting gingival retractions. The other factors had no significant influence on the outcome of surgery.

Alveolar Process↗

Craniofacial surgery for trauma.

Craniofacial surgical techniques have yielded as an important spin-off better methods of treating severe craniofacial trauma. In this paper surgical techniques are discussed. It was concluded that the most important factors for successful reconstruction after craniofacial trauma is to do as much as possible the first time, to obtain wide exposure, ensure rigid fixation of bone pieces and grafts and to make use of a work bench procedure where bone fragments are assembled on a side table for subsequent reattachment to the head.

Adult↗

The craniofacial approach to trauma.

Craniofacial surgical techniques have yielded better methods of treating severe craniofacial trauma. In this paper surgical techniques are discussed in principle and specifically presented through case reports. We conclude that the most important factors for successful reconstruction after craniofacial trauma are to do as much as possible the first time, to obtain wide exposure, to ensure rigid fixation of bone pieces and grafts, and to make use of a workbench procedure where bone fragments are assembled on a side table for subsequent reattachment to the head.

Adult↗

Airway obstruction and sleep apnea in children with craniofacial anomalies.

Children with severe craniofacial anomalies and breathing problems are rare, and the accumulated experience of their treatment is limited. LeFort III midface advancements have been tried by many craniofacial teams, but no consensus has yet been reached as to the effectiveness of this procedure. In this report of seven patients with craniofacial malformations and severe breathing problems, three had a LeFort II midface advancement, one had release of bilateral temporomandibular joint ankylosis, and two had tonsillectomies. Two patients without a tracheostomy suffocated, four had a long-term tracheostomy, and one was cured by a unilateral tonsillectomy. It was concluded that LeFort III midface advancement is ineffective in these types of cases without a very stable postoperative retention, and it was suggested that all patients with severe craniofacial anomalies and breathing problems, regardless of their planned subsequent treatment, should have a tracheostomy as an initial measure.

Acrocephalosyndactylia↗

Microsurgical replantation of a total scalp avulsion. Case report.

In June 1982, a 9-year-old girl sustained a total scalp avulsion including the entire right eyebrow, the upper third of the skin of the dorsum of the nose and the medial half of the left eyebrow. On both sides the temporal skin was included and in the neck a border of just 1 cm of hairbearing area was left intact. The scalp was successfully replanted. The operative procedures, the pre-operative and post-operative treatment are described and discussed. The follow-up time is 3 years and the sequelae have been found to be minimal.

Amputation, Traumatic↗

Multiple craniofacial surgical interventions during 25 years of follow-up in a case of giant fibrous dysplasia. Case report.

Fibrous dysplasia may affect the jaws as a monostotic lesion which most often ceases to be active at the end of normal bone growth. In some cases there is no stabilization on completion of normal skeletal growth. This may lead to severe malformation and functional disturbance to the face. In these cases, the patient must be followed regularly and resection of the deformed tissue must be performed repeatedly as the recurrences appear. Attention is also brought to the fact that fibrous dysplasia may be difficult to separate from chronic sclerosing osteomyelitis, a condition that should be treated differently.

Adult↗

Facial disassembly for tumor resection.

A standardized method of surgical dismantelling of the face for access to the periorbital area is described in detail. Its use in 11 patients with periorbital tumors is described and illustrated by selected case reports. It was concluded that many tumors in the periorbital area that previously were considered inoperable with craniofacial disassembling techniques can be adequately treated without sacrificing eyes or mutilating the face.

Adult↗

Skull morphology after early craniotomy in patients with premature synostosis of the coronal suture.

The degree of normalization of the shape of the skull was studied in 12 craniosynostosis patients who had been treated with different types of craniotomies in infancy. Three diagnoses were represented: isolated bicoronal synostosis; Crouzon's syndrome; and Apert's syndrome; there were four subjects in each group. Selected cranial dimensions were measured on roentgencephalograms taken in infancy and at follow-up examinations at 2 to 3 years of age. The measurements were compared with control values obtained from patients with cleft lip. Cranial dimensions in the synostosis patients seldom corresponded well with the values of the controls, either before or after surgery. Cranial height, in particular, was increased, especially in patients with Crouzon's or Apert's syndrome. This resulted in modulus values above the control mean for 11 of the 12 patients at the follow-up examinations.

Acrocephalosyndactylia↗

Cephalometric radiography and computed tomography in infants undergoing craniofacial surgery.

A program for preoperative workup and post-operative follow-up in children with craniofacial anomalies is described. Objective measurements were made with cephalometry and computed axial tomography. Improvement in length of the anterior cranial base and shape of the calvaria after surgery and growth was demonstrated in this manner in serial follow-ups. It was concluded that both cephalometry and computed tomography were essential for the diagnosis, surgical planning and follow-up for this group of patients.

Cephalometry↗