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Biomedical subjects

M B Habal

Publications and source records attributed to M B Habal.

At least 109 records · Page 6Linked to original sources

Aesthetic considerations in the reconstruction of the anophthalmic orbit.

Twenty-four patients with severe anophthalmic orbit syndrome were treated with a combination of techniques utilizing autogenous tissue. Autogenous corticocancellous bone grafts were used in the orbit as a volume filler. The temporalis muscle and a fasciae flap with a pericranial flap were used as a curtain to cover the bone grafts and to give a softening effect. The prosthesis used was a regular eye shell. With this method it can be smaller, thinner, and lighter to produce less deformation of the lower lid, particularly when used for a long period of time. In children who have this deformity compounded by small orbits after oncologic treatment, three-wall orbital enlargement is done to achieve a larger orbit, so as to match the normal unaffected socket and produce symmetry.

Adolescent↗

Large congenital melanocytic nevus. Light and electron microscopic findings.

The family of a 10-month-old black girl with a large periocular congenital melanocytic nevus (CMN) was given markedly differing advice from experienced physicians regarding how the lesion should be managed. The nevus was eventually removed surgically because of concern about the risk of malignant transformation and because of its cosmetic appearance. Histologically, the lesion was a dermal nevus, but extended deeply into subcutaneous tissue and had neuroid features. The ultrastructural characteristics of melanocytes varied according to the depth at which they resided, but cells did not differ basically from melanocytes found in smaller acquired nevi. Given the limited understanding of the biologic basis for malignant transformation, large size remains the most important risk factor in CMN.

Child↗

Postnatal palatoplasty, implications for normal speech articulation--a preliminary report.

During the last ten years patients born with cleft palates had their palates closed between three and eight months of age. The primary objective has been to have the clefts closed soon to minimize faulty habits of speech articulation and intraoral, oropharyngeal and laryngeal compensatory movements for speech. Over one hundred ninety patients with a variety of cleft types were treated. Of these patients, twenty-two were randomly selected for complete and comprehensive evaluation one to eight years after the corrective procedure. Oro-nasal balance of articulatory resonance was noted. There was not any need for secondary palatal procedures in any of the patients, and no deleterious effects on facial growth were found. Normal articulation development was observed in all the patients treated by this methodology as measured by a standardized test and developmental norms.

Cleft Palate↗

Psammomatoid ossifying fibroma.

Fibro-osseous lesions represent a variety of bone proliferations each characterized by different morphologic patterns of osteoid production. Psammomatoid ossifying fibroma (POF) is characterized histologically by numerous small round ossicles resembling psammoma bodies and is a locally invasive lesion of facial and cranial bones. Two cases of POF arising in the ethmoid sinus and involving the orbit are presented to emphasize the importance of complete surgical removal of involved bones. Histologically, portions of POF may demonstrate other patterns of osteoid production, which resemble fibrous dysplasia and Paget's disease of bone. The variation in radiodensity in POF on computed tomography is a function of the density of psammomatoid ossicles and of the coexistence of other "minor" forms of bone proliferation.

Child↗

A carotid cavernous sinus fistula after maxillary osteotomy.

A patient is presented who developed carotid cavernous sinus fistula 1 year after midface advancement. The symptoms of carotid cavernous fistula of buzzing in the ear, proptosis, and chemosis were prescriptive evidence of the occurrence of the fistula. The diagnosis was confirmed by arteriography. The patient was treated successfully. This is a rare unfavorable result from this major craniofacial surgery and is presented to alert those in the field to its occurrence.

Adult↗

Prevention of postoperative facial edema with steroids after facial surgery.

A one-bolus (dose) of 1 g of methylprednisolone was administered intravenously to patients undergoing facial surgery or craniofacial surgery, before the termination of the operative procedure. The degree of facial edema noted was reduced, and when it occurred, it was mild and of shorter duration. These observations were made on the experimental design first, and later in the clinical setting. No adverse effects were noted, and patients given this treatment required less pain medication in the immediate postoperative period. The mechanism of action of the steroids is multifactorial, related to decrease in the accumulation of fluid at the capillary level, and reduction of flow at the venoarterial sphincters. The use of steroids is safe when used with caution in selected patients, and by experienced surgeons.

Edema↗

Autologous corticocancellous bone paste for long bone discontinuity defects: an experimental approach.

A number of materials have been used in treating long bone discontinuity defects, some with rewarding results and some without. These materials vary from autologous, allogenic, and xenogenic grafts, to bone implants. Other inorganic implants, such as plaster of Paris and gold, have been used, most inducing a strong inflammatory reaction. In this experiment, a paste of autologous corticocancellous bone particles was used to reconstitute discontinuity defects in long bones. The defects were healed to a solidified state within six months. This finding confirms our previous work; in membranous bone discontinuity defects, autologous corticocancellous bone gave best overall results either when used alone or with a template carrier for contouring purposes.

Animals↗

The biologic basis for the clinical application of the silicones. A correlate to their biocompatibility.

The polysiloxanes (silicones) are a group of inert and inorganic compounds that were introduced over two decades ago. The pure form, termed medical-grade silicone, has a wide variety of clinical applications. Almost all surgical fields have used a product made of silicone. Silicone has been found to be an inert material, with minimal reaction of the biologic system to its presence. However, multiple clinical problems still exist due to certain applications of silicone products. The problems are related to its surface properties; In the blood thrombi form around silicone implants that may dislodge and cause symptoms around the implants. Scar formation may occur, and internal wound healing problems in the breast cause spherical contracture. In the eyes, where transparencies are needed, as in the intraocular lens implant, the scar interfaces with the visual image transmissions. Some of these internal problems relate to the hydrophobic nature of the silicone surface and have been resolved in part by adsorbing a wetting agent, such as povidone, to the surface. Such obviation has gained wide clinical application in surface coating of the intraocular lens. In search of an ideal implantable material, silicone, the most applicable, is still far from being called the ideal implant. Perhaps with the changes of its surface properties, such as introducing wetting agents to its surface, a new dimension in clinical applications will open the horizons of silicone in the 1980s.

Animals↗

A survey of nursing care for parents and infants with cleft lip and palate.

This survey of the hospital nurse's role in patient care when a child is born with an orofacial cleft included nursing assistance offered new parents, identification of specialists for habilitation of the child, and inservice nursing education programs. Findings from 52 hospitals indicated that adequate assistance and information concerning special services for parents and child were not available. Some hospitals offered inservice nursing education in care of parents and children with facial clefts. Suggestions are made concerning nursing education programs in cleft lip and palate.

Adult↗

Lateral facial clefts: closure with W-plasty and implications of speech and language development.

Lateral facial clefts are rare; their incidence is about 1 in 60,000 births. Early treatment with closure in layers is stressed. The mucosa is closed in with a Z-plasty to avoid intraoral band contracture, the orbicularis muscle is closed after interfiber reorientation, and the skin is closed with W-plasty to produce a more aesthetic result and avoid the fissure-like appearance. A familial incidence is noted. Language development is observed before and after the surgical corrective procedure.

Adult↗

The aesthetics of the preauricular graft in facial reconstruction.

In the past six years we have used 55 preauricular full-thickness skin grafts to reconstruct defects of the nose, medial canthal area, forehead, and lip. Results have been good to excellent in all cases. The donor incision is the same one used for a rhytidectomy in which the sole reason for operation is cosmetic. Hence the donor scar in this area must certainly be considered cosmetically acceptable.

Face↗

Surgical management of "pus-pot" perineum.

Ten cases of disabling "pus-pot" perineum secondary to hidradenitis suppurativa, urethral stricture disease, condyloma acuminatum and anoperineal fistula were treated by wide excision of involved tissues. In 7 men the testicles were transposed to thigh pouches, and in 3 the entire penile skin was excised and replaced with a skin graft.

Adult↗

Categorization of craniofacial deformities based on our experience with surgical manipulation.

A wide variety of deformities are seen by the craniofacial team. To facilitate the coding and retrieval of data collected, a system has been devised in which an attempt is made to transfer different clinical problems into units which can be processed more efficiently and encoded more exactly. The different surgical manipulations used form the basis of this system. Careful forethought and understanding are prerequisite for the utilization of this system by the craniofacial team.

Abnormalities, Multiple↗

Observations on the ultrastructure of the pericranium.

The pericranial membrane is of great interest in corrective and reconstructive procedures of the craniofacial region. A close look at its ultrastructure reveals that the outer layer is made up of loose areolar tissue and fibroblasts, and the inner layer of osteoblasts. A network of vessels near the inner layer accounts for the ability of the pericranial layer to be used as a flap based on a narrow pedicle.

Facial Bones↗