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Biomedical subjects

L F Stassen

Publications and source records attributed to L F Stassen.

29 records · Page 2Linked to original sources
PubMed1993

An in-vitro study of the comparative viability on different swab types of simulated specimens of bacteria commonly present in oro-facial infections.

An in-vitro study was undertaken to investigate the survival on bacteriological swabs of three potentially pathogenic organisms found in oro-facial infections, by using simulated clinical specimens incubated in the presence or absence of Amies transport medium. Standard inocula of pure cultures of Streptococcus milleri, Prevotella melaninogenica and Peptostreptococcus anaerobius were soaked on to swabs and plated out on to solid media at various intervals up to 3 days, enabling an estimate of their viability to be made following further incubation. Differential survival of the three test organisms was observed, with Streptococcus milleri being generally the hardiest and Peptostreptococcus anaerobius the least hardy, whilst survival was consistently enhanced by the presence of a transport medium. Recovery of Prevotella melaninogenica was improved by incubation for 5 days. We conclude that transport swabs should be used in preference to plain swabs whenever immediate laboratory culture cannot be assured, to avoid loss of anaerobic bacteria.

Bacteria↗
PubMed1992

Ophthalmic consequences of mid-facial trauma.

Fractures of the mid-face are commonly accompanied by injury to the visual system. Three hundred and sixty three patients who had sustained mid-facial fractures were assessed prospectively for evidence of such injury. The data have been used to devise a scoring system for the maxillofacial surgeon in order to help identify those patients at risk of eye injury. The scoring system has been evaluated on a further cohort of 100 patients with a similar spectrum of injury and the sensitivity and specificity of the system have been determined. The results of these studies have been reported in the maxillofacial literature. This paper reviews the data and results obtained. In summary, impaired visual acuity with a comminuted or out blow fracture, a motility abnormality, or facial fracture combined with head injury, sufficient to cause both retrograde and post-traumatic amnesia, emerged as major risk factors which are indicative of an adverse ophthalmic outcome deemed to warrant referral. The scoring system which was developed from this data was found to have a sensitivity of 94.4% and a specificity of 89% for the detection of patients thought to merit ophthalmic assessment. Failure to assess central visual function as objectively as practicable in patients who have sustained mid-facial fractures may lead to potentially treatable ophthalmic pathology not being identified.

Diplopia↗
PubMed1991

Midfacial fractures and the eye: the development of a system for detecting patients at risk of eye injury.

Maxillofacial trauma is often complicated by injury to the eye. Such injuries may be difficult to detect and may therefore be missed. Detailed ophthalmic examinations were carried out prospectively on 363 patients who had sustained midfacial fractures. Fifty four parameters comprising maxillofacial, radiological and ophthalmic data were recorded and coded for each patient. All encoded data were divided into predictors (the data potentially available to the maxillofacial surgeon) and outcome (the data potentially available to the ophthalmologist). Statistical methods of regression, and the analysis of contingency tables, led to the identification of the principal predictors indicative of underlying ophthalmic injury and thence to a scoring system which predicts the severity of such injuries. Impaired visual acuity is the principal predictor and when employed alone gives a sensitivity value of 80%. Pure blow-out fracture or comminuted facial fracture, double vision and amnesia emerged as additional factors which yielded an efficient scoring system with a sensitivity of 89% and specificity of 90% for the population upon which it was based. A score sheet is provided in the paper. These predictors can be remembered from the acronym Blow-out fracture, Acuity, Diplopia, Amnesia, Comminuted Trauma. As many such injuries result from a BAD ACT, it is easily remembered. This scoring system requires to be tested upon a new population of individuals in order to determine its efficacy.

Amnesia↗
PubMed1991

The characteristics of midfacial fractures and the association with ocular injury: a prospective study.

Ocular injuries commonly occur in patients with facial fractures. This prospective study was set up to determine the incidence of ocular injuries, as assessed by an ophthalmologist, in patients who had sustained midfacial fractures. Over a 2-year period, a study of 363 patients who had sustained midfacial trauma sufficient to lead to a facial bone fracture (438 fractures) was undertaken and patients received a comprehensive examination by an ophthalmologist and an orthoptist within 1 week of injury. The characteristics of the eye injuries sustained were related to the aetiology of the fracture, the type of fracture, and the sex and age of each patient. Ninety percent of patients sustained ocular injuries of various severities. Sixty three percent of patients sustained only minor or transient ocular injuries, 16% suffered moderately severe ocular injury and 12% experienced severe eye injuries. Road traffic accident was associated with the highest incidence of severe ocular disorder (9/45 = 20%) whilst assaults had the second highest incidence at 11% (20/181). One third of all patients with comminuted malar fracture suffered a severe ocular disorder (9/27) whilst blow-out fracture came second at 16.7% (6/36). Fifty six patients (15.4%) had a decrease in their visual acuity and 9 patients (2.5%) had significant traumatic optic neuropathy. Decrease in visual acuity was the main clinical finding accompanying the majority of significant eye injuries. When ocular injuries were related to aetiology, it was apparent that road traffic accidents and assaults associated with alcohol abuse showed the highest incidence of major ocular dysfunction. It is suggested that all patients sustaining midfacial fracture associated with a significant decrease in visual acuity either pre- or postoperatively should have an early ophthalmological review.

Accidental Falls↗
PubMed1991

Diplopia following midfacial fractures.

Over a period of 2 years, 363 patients who had sustained a total of 438 midfacial fractures due to blunt trauma received a full ophthalmological examination within 1 week of injury. Of these, 72 patients (19.8%) developed diplopia. Diplopia was most common following road traffic accidents (31%) and least common with simple falls (10%). Blow-out fractures of the orbit led to double vision in 58% of cases. Eighty two percent of patients recovered from diplopia within 6 months of injury; only 1 patient required squint surgery for double vision. The principal risk factors for diplopia comprise road traffic accidents, blow-out fractures and comminuted malar fractures. Early surgical reconstruction of midfacial fractures with conservative management of concomitant motility disorders has, in our series, resulted in very few patients having diplopia in the long term.

Accidents, Occupational↗
PubMed1989

Purtscher's retinopathy: an unusual association with a complicated malar fracture.

A case in which a malar fracture was associated with Purtscher's retinopathy with its accompanying impairment of vision is described. The literature concerning this uncommon condition is reviewed and its aetiology discussed. This case reinforces the importance of visual acuity testing and funduscopy following maxillofacial trauma, not only at presentation but throughout the patient's management.

Blindness↗
PubMed1989

A comparison of the use of external pin and transnasal Kirschner wire fixation for the unstable tripod malar fracture: a prospective trial.

A prospective study involving 54 patients was undertaken to compare external pin and transnasal Kirschner wire (K-wire) fixation of the unstable, non-comminuted, tripod malar fracture. The features assessed were: (1) The aesthetic result. (2) The ease and speed of both procedures. (3) Per-operative complications. (4) Post-operative complications. (5) Patient tolerance of the procedure.

Adult↗
PubMed1989

Cancrum oris in an adult Caucasian female.

This paper reports a case of cancrum oris in an adult Caucasian female who had no obvious pre-disposing cause. It highlights the difficulties in making this diagnosis in a part of the world unaccustomed to seeing the disease and it illustrates that early surgery and reconstruction can be undertaken. To our knowledge, this is the first published case of cancrum oris reconstructed with the use of micro-vascular free tissue transfer.

Face↗
PubMedDate not supplied

Periosteal fasciitis of the mandible.

BACKGROUND: Periosteal fasciitis is rare in the head and neck. We believe only two cases of fasciitis-induced erosion through the mandibular cortical plate have previously been reported. RESULTS: Management of a case of periosteal fasciitis with bone erosion at the mandibular angle is reported in a 38-year-old man. CONCLUSIONS: Misdiagnosis of fasciitis in the past has led to inappropriate management and unnecessary morbidity. The principles of diagnosis and management of this unusual and confusing disorder are highlighted.

Adult↗