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Biomedical subjects

K E Salyer

Publications and source records attributed to K E Salyer.

At least 19 recordsLinked to original sources
PubMed1992

Demineralized perforated bone implants in craniofacial surgery.

Between July 1990 and September 1991, demineralized perforated allogeneic bone implants (Pacific Coast Tissue Bank, Los Angeles, CA) were placed in 72 patients. Because many patients received more than one implant, a total of 248 implants were used in 80 procedures. The technology of processing demineralized bone implants is described in detail. All patients were operated on by one surgeon (K.E.S.) at the Humana Craniofacial Institute in Dallas, Texas. Forty-one patients had craniofacial deformities, 16 had secondary deformities following cleft lip and palate repair, 8 had bony defects following removal of tumors, and 10 had various skeletal deformities following trauma. Of the 72 patients, 6 had two surgical procedures during which additional implants were inserted. Implants placed in the cranial vault and the maxillary complex, including alveolar grafts, were inlay grafts, whereas implants placed in the orbital, nasal, paranasal, temporal, and malar areas were onlay grafts used for contouring, augmentation, or both. Complications were limited to delayed wound healing in 6 patients. According to our observations, demineralized perforated bone implants represent an encouraging alternative to autogenous bone grafting. Further clinical and experimental studies are necessary to obtain more information about this material.

Adolescent↗
PubMed1992

Early and late treatment of unilateral cleft nasal deformity.

Surgical techniques have been developed to correct nasal deformity associated with unilateral cleft lip, alveolus, and palate. This deformity can be significantly corrected during the primary cleft lip repair, as performed by the technique described by the author. Secondary corrective procedures focus mostly on skeletal support and lining distortions as well as on rearrangements of lower lateral cartilages. At the final stage, esthetic appearance can be significantly improved by contour remodeling with the addition of cartilage and/or bony implants. Choice of surgical technique depends upon the severity of the deformity and the experience and proficiency of the surgeon. At the present time, correction of the nasal deformity associated with a unilateral cleft is an integral part of primary cleft lip repair and part of multidisciplinary management of cleft deformities.

Adult↗
PubMed1991

Growth status of children treated for unilateral cleft lip and palate.

Cephalometric distances, angles, and proportions were evaluated for 32 children 5 to 8 years of age treated for unilateral cleft lip and palate. The children were age and sex matched with untreated controls with normal skeletal relationships. The unilateral cleft lip and palate sample was treated by the same surgeon and orthodontist using the same techniques and appliances. Measures of overall facial proportions, facial convexity, and prognathism were not significantly different between the two groups. The primary group differences pertain to the posterior aspect of the maxilla, which is vertically short in the unilateral cleft lip and palate sample. Horizontally, the maxilla of the unilateral cleft lip and palate children was significantly longer, producing a steeper palatal plane. In addition, the zygoma and orbits of unilateral cleft lip and palate children were somewhat retruded; the posterior cranial base and total mandibular length also were longer in the unilateral cleft lip and palate children.

Analysis of Variance↗
PubMed1990

Bandeau--the focal point of frontocranial remodeling.

Reconstructing the proper balance and harmony of the face begins with the manipulation and positioning of the bandeau. The bandeau or brow is the key architectural component of craniofacial reconstruction. Advancement of the supraorbital bar and forehead can result in functional improvements. This article details the historical development of the surgical procedures available for use in recontouring the forehead. Specific surgical procedures are described and evaluated including the method of removing an unsuitable, unusable bandeau, fashioning a new one from a strip of parietal cranial bone, and repositioning it. The advantages of the bilateral lamellar split bandeau are discussed.

Adult↗
PubMed1990

Lamellar split osteotomy: a new craniofacial technique.

Craniofacial osteotomies have by convention been bilamellar translocations of the entire substance of the dysmorphic bone. This approach limits the surgeon by reducing the stable bone mass available for fixation, creating dependence on concave surfaces. Most important, it changes the bony topography that determines the preoperative plan. This paper presents a new craniofacial concept and technique used in 26 patients with various dysmorphic syndromes who were reconstructed by performing a lamellar split osteotomy. This technique maintains the internal lamella in its native position, thereby allowing it to act as a reference for the bony topography and providing a stable facial framework for rigid fixation. This interlamellar osteotomy has led to improved aesthetic results in the orthomorphic reconstructions of congenital and other deformities. It can be used in any aesthetic patient in whom contour changes or augmentation of form is desired. It is recommended as a preferred method for achieving quantitative contour improvement in patients over 3 years of age.

Adolescent↗
PubMed1989

Porous hydroxyapatite as an onlay bone-graft substitute for maxillofacial surgery.

This paper chronicles 3 years of a continuing study comparing porous hydroxyapatite to autogenous bone grafts as onlays in maxillofacial surgery. Twenty-five patients, seen from June of 1984 to May of 1985, underwent onlay augmentation on various maxillary and mandibular locations. A total of 68 onlay augmentation sites comparing Interpore porous hydroxyapatite and autogenous bone were followed for 2 years or more. This long-term study compares these substances in radiologic longevity, histologic incorporation, clinical function, and aesthetic appearance.

Adolescent↗
PubMed1989

Effects of craniofacial deformity in infancy on the quality of mother-infant interactions.

Self-report and behavioral observation procedures were used to assess the quality of mothers' interactions with facially deformed infants. This assessment strategy also provided an opportunity to evaluate the hypothesis that parents of facially deformed infants may deny or be unaware of deficits in their relationships with these children. 10 mothers, 5 with unattractive/craniofacially deformed infants and 5 with normal infants, completed self-report measures of stress, social support, satisfaction with parenting, and general life satisfaction. Mother-infant interactions were videotaped and rated on discrete and global behavioral measures. Results revealed that mothers of deformed infants rated their parental satisfaction and current life satisfaction more positively than did mothers of normal infants. However, these same mothers were observed to behave in a consistently less nurturant manner than mothers of normal children. These results suggest that infant facial deformity/unattractiveness may affect the quality of infant-caregiver interactions without parental awareness.

Adult↗
PubMed1989

The use of videonasopharyngoscopy for biofeedback therapy in adults after pharyngeal flap surgery.

Nasopharyngoscopy with videorecording was used as a visual feedback therapy tool to establish and promote consistent closure of the velopharyngeal ports during connected speech after pharyngeal flap surgery. Of the three adults in this report, two achieved consistent closure during connected discourse and have been discharged from therapy; the third demonstrated improved velopharyngeal closure but elected not to continue therapy. These outcomes demonstrate that nasopharyngoscopy biofeedback therapy is useful in helping the motivated adult to achieve better velopharyngeal closure during connected speech after pharyngeal flap surgery or revision. This type of therapy may also prove beneficial with children.

Adult↗
PubMed1988

The physical attractiveness of facially deformed patients before and after craniofacial surgery.

The present experiment investigated whether the physical attractiveness of craniofacially deformed children and adolescents could be improved by surgical procedures. Twenty patients between the ages of 5 months and 17 years were randomly selected from patient files. Patient diagnoses included facial clefts, hypertelorism, Treacher Collins syndrome, and craniofacial dysostosis (Crouzon's and Apert's syndromes). Rigorously standardized photographs of patients taken before and after surgery were shown to 40 "naive" raters ranging in age from 17 to 52 years. Raters analyzed the photographs with regard to global physical attractiveness. These ratings indicated that the patients' physical attractiveness was reliably (62 percent) improved following surgery. The results are discussed in light of recent evidence that untreated craniofacial patients may be at risk for psychosocial disorders and in terms of the growing evidence of the importance of physical appearance for the development of cognitive and social-emotional competence. In addition, a standardized assessment system is described that can be used to facilitate the compilation of actuarial data predicting surgical outcomes. Finally, the importance of empirically evaluating the effectiveness of surgical procedures and practitioners on a continuing basis is emphasized.

Adult↗
PubMed1988

Emotional and behavioral reactions to facially deformed patients before and after craniofacial surgery.

The present experiment investigated whether observers' emotional and behavioral reactions to facially deformed patients could be substantially improved by surgical procedures conducted by well-trained specialists in an experienced multidisciplinary team. Also investigated was the hypothesis that emotional states mediate the effects of physical attractiveness and facial deformity on social interaction. Twenty patients between the ages of 3 months and 17 years were randomly selected from over 2000 patients' files of Kenneth E. Salyer of Dallas, Texas. Patient diagnoses included facial clefts, hypertelorism, Treacher Collins syndrome, and craniofacial dysostoses (Crouzon's and Apert's syndromes). Rigorously standardized photographs of patients taken before and after surgery were shown to 22 "naive" raters ranging in age from 18 to 54 years. Raters were asked to predict their emotional and behavioral responses to the patients. These ratings indicated that observers' behavioral reactions to facially deformed children and adolescents would be more positive following craniofacial surgery. Similarly, the ratings indicated that observers' emotional reactions to these patients would be more positive following surgery. The results are discussed in terms of current sociopsychologic theoretical models for the effects of attractiveness on social interaction. A new model is presented that implicates induced emotional states as a mediating process in explaining the effects of attractiveness and facial deformity on the quality of social interactions. Limitations of the current investigation and directions for future research are also discussed.

Adolescent↗
PubMed1987

Bone grafts in craniofacial surgery.

Bone grafting or bone replacement is an integral part of craniofacial surgery. Most craniofacial surgeons prefer the use of autogenous bone; however, there are exceptions to this, because some plastic surgeons prefer the use of alloplastic implants for replacement of parts or missing segments in the craniomaxillofacial skeleton. Inlay bone grafts are useful in osteotomies because they show little resorption. Onlay bone grafts contour and balance the face aesthetically and enable the surgeon to obtain refinement and fine-tuning in all types of craniofacial reconstruction. These grafts demonstrate more resorption than inlay grafts. However, the use of onlay grafts coupled with soft-tissue shifts of galea and muscle enable the craniofacial surgeon to achieve superior results over those of surgeons primarily concerned with jaw- or tooth-related movements that do not utilize primary bone grafting as a method of augmentation. Superior results today are obtained with various methods and techniques of bone grafting, some of which have been described in this article.

Abnormalities, Multiple↗
PubMed1986

Primary correction of the unilateral cleft lip nose: a 15-year experience.

This paper reviews a 15-year personal experience based on 400 unilateral cleft nasal deformities that were reconstructed using a method that repositions the alar cartilage by freeing it from the skin and lining and shifts it to a new position. The rotation-advancement lip procedure facilitates the exposure and approach to the nasal reconstruction. The nasal soft tissues are transected from the skeletal base, reshaped, repositioned, and secured by using temporary stent sutures that readapt the alar cartilage, skin, and lining. The nasal floor is closed and the ala base is positioned to match the normal side. Good subsequent growth with maintenance of the reconstruction has been noted in this series. The repair does not directly expose or suture the alar cartilage. Improvement in the cleft nasal deformity is noted in 80 percent of the cases. Twenty percent require additional techniques to achieve the desired symmetry. This method has been used by the author as his primary unilateral cleft nasal repair and has been taught to residents and fellows under his direction with good results. This technique eliminates the severe cleft nasal deformity seen in many secondary cases.

Child↗
PubMed1986

Three-dimensional CAT scan reconstruction--pediatric patients.

Pediatric craniofacial deformities are highly complex disorders. The development of high-speed computers and related software has recently permitted three-dimensional graphics reconstruction of these deformities based on CT and NMR scan data. Such three-dimensional reconstructions are highly useful in the diagnosis, preoperative planning, and postoperative assessment of these complex deformities.

Adolescent↗
PubMed1984

Use of a new hemostatic scalpel in plastic surgery.

This assessment of a new hemostatic scalpel in plastic surgery is based on one surgeon's personal experience with this instrument in 348 cases representing a variety of procedures. With its improved hemostatic capabilities the hemostatic scalpel may offer the following advantages: better visualization of the surgical field, enhanced precision, and more delicate control. Considerable time and experience are necessary, however, before the scalpel can be used safely and competently.

Breast↗