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M Merkel

Publications and source records attributed to M Merkel.

59 records · Page 4Linked to original sources

Bone tunnel enlargement after anterior cruciate ligament reconstruction with semitendinosus tendon using Endobutton fixation on the femoral side.

We evaluated 29 knees with a minimum follow-up of 2 years after anterior cruciate ligament (ACL) reconstruction using doubled autogenous semitendinosus tendons. On the femoral side, a 5-mm Mersilene tape (Ethicon, Norderstedt, Germany) with an Endobutton (Acufex Microsurgical, Mansfield, MA) was used. The tendon was fixed on the tibial side with two staples. Regarding the IKDC score, 66% of the patients were graded as normal or nearly normal. The anterior laxity side-to-side difference (KT 1000, man-max-drawer) was under 3 mm in 55% and under 5 mm in 90%. Radiographs taken in the lateral and anteroposterior projections of the knee showed sclerotic bone tunnel margins. The diameter of the bone tunnels were measured, corrected for magnification, then compared with the original reamed diameter to determine any change in size. Enlargement of at least 2 mm was identified in 72% of the femoral tunnels and 38% of the tibial tunnels. No correlation was found concerning the enlargement of the tunnel and the IKDC score or the residual joint laxity. We conclude that using an Endobutton-Mersilene construct in ACL reconstruction leads to femoral and tibial bone tunnel enlargement at follow-up of 2 years.

Anterior Cruciate Ligament↗

Computed tomography in the assessment of mandibular invasion by intraoral carcinoma.

A critical factor in the pretreatment evaluation of patients with carcinoma of the oral cavity or oropharynx is the presence or absence of bone invasion. A prospective study was performed to compare the sensitivity and specificity of plain radiographs and computed tomography in detecting mandibular invasion by cancer arising in these sites. Forty-three consecutive patients with previously untreated oral cavity or oropharyngeal carcinoma were evaluated preoperatively by intraoral radiographs (dental occlusal views and panoramic radiographs) and CT, and the results were compared with postoperative pathologic findings. Of the 11 cases in which pathologic examination confirmed bone invasion, conventional x-ray films were positive in seven (63.6%). Computed tomography confirmed bone invasion in all 11 (100%) of these patients. In addition, the CT scan was more specific than conventional x-ray films in detecting bone invasion. Based on the findings in this study, we strongly recommend CT as the only radiographic study necessary to evaluate intraoral carcinoma prior to treatment.

Aged↗

Asymptomatic laryngocele: incidence and association with laryngeal cancer.

Since laryngoceles are usually asymptomatic, their incidence is probably higher than the literature suggests. With the advent of computed tomography, the incidence and significance of the asymptomatic laryngocele in a general head and neck practice can be addressed. To this end, 304 consecutive patients with a variety of otolaryngic diagnoses were studied prospectively by computed tomography of the neck from January 1983 to February 1985. Thirty-eight (12.5%) of the patients had asymptomatic laryngoceles, defined as air-containing structures in the supraglottic region extending more than 5 mm above the superior border of the thyroid cartilage during normal breathing. The incidence of laryngoceles associated with laryngeal cancer (29%) was higher than that for laryngoceles associated with other diseases (9%). No patient with an asymptomatic laryngocele not associated with laryngeal cancer showed evidence of a subsequent laryngeal neoplasm during close follow-up of 10 to 36 months.

Carcinoma, Squamous Cell↗