Biomedical subjects

M Stricker

Publications and source records attributed to M Stricker.

At least 19 recordsLinked to original sources

PubMed2002

Diagnosis and treatment of vascular lesions of the lip.

Many vascular lesions involve the lip. We present the clinical and imaging findings of vascular lesions, including haemangiomas and vascular malformations. We review the changing role of surgery and other treatments in the management of each type of lesion. Haemangiomas are treated surgically only when lip function is substantially impaired. Superselective embolisation is the treatment of choice for arteriovenous malformations, whereas capillary-venous malformations are best treated by operation together with intralesional injection of fibrosing agents. Capillary malformations are usually treated with laser.

Adolescent↗

PubMed2002

[Morphologic disequilibrium of the lips].

The aetiologies of the labial desequilibrium are multiple. They respond to the anomalies of the position and the dimension. The authors will enumerate the different variety and their etiology.

Adult↗

PubMed2002

[Red lip defects. Reconstructive techniques and indications].

The attractive color of the red lip must be the object of very meticulous reconstruction in their form and pigmentation. This can be done only by using the buccal mucosa. The graf is less indicated. There are multiple local flaps that have been proposed using the same lip, the jugal mucosa and the tongue. The authors will show the principal procedures found in the literature.

Humans↗

PubMed2002

[Labial aging. Composition and therapeutic principles].

Labial ageing process combining relaxation, distension and ptosis is aggravated by underlying structure modification: dental and bony. If the inferior lip moves back and collapses, the superior lip will go down and widen. The authors analyse the different ageing process components (intrinsic and extrinsic) as well as therapeutic principles.

Adolescent↗

PubMed2002

[Full thickness defects of the lips. Reconstructive techniques and indications].

The full-thickness tissue loss of the lip leads to the loss of lip continuity. The classic principle is to repair a lip with a lip, giving the best results. Although the size of tissue lost can force to use local flaps, these could be naso-labio-jugal, labio-mental or submental. Even though the microsurgical labial replantation is the technique of choice, unfortunately, most of the time it cannot be done as a result of the situation and the conservation of the avulsed fragment.

Humans↗

PubMed2002

[Labial commissures. Reconstructive procedures and indications].

The commisures are the two extremities of the mouth. They make a big complex in their architecture and their function. Their repairing should have an important attention to their final shape and function. The frequency of the retraction of the scarring tissue imposes additional muscular exercise which has to be premature, intense, and prolonged.

Humans↗

PubMed2002

[Labial balance].

The labial balance appreciated by statics and movement is the guarantee of morphology, bilabial competence and symmetry in function (ou bien in movement?). The restoration of the lips aims for this balance, the basic axiom is "to repair the lip by the lip". Three main technical forms meet these requirements: forward movement, rotation and transposition.

Biomechanical Phenomena↗

PubMed2001

[Development of the maxilla in patients with complete unilateral cleft palate surgically treated by a periosteal transplantation technic. A retrospective study of 15 surgical cases with an 18 year follow-up].

PURPOSE: The aim of this study was to assess retrospectively the long-term growth of the maxilla in subjects with unilateral total cleft treated initially with the tibial periosteal graft technique. PATIENTS AND METHODS: The study group included 15 patients with a mean 18 years follow-up (range 15-20 years). All patients had been operated on by the same surgeon. Only patients in stage DP3, one to two years after peak growth were retained for review. Delaire's architectural analysis was used to study anteroposterior and vertical growth of the maxilla. Transverse growth was studied with the Mars occlusal score. Bone generation induced by the periosteum was studied using the Björk Holmgren analysis. The quality of the palatine and nasal repair was studied using Pruzansky's criteria. RESULTS: Anteroposterior and vertical growth led to a normal maxilla in 53.3% of the cases and a moderate to severe retromaxilla (> 5 mm) in 46.7%. Complete symmetry was achieved for the nasal fossae in 20% of the cases and marked asymmetry was noted in 26%. The height of the nasal fossae was symmetrical in 60% of the cases with marked asymmetry in 26%. Mean production of alveolar bone reached 58% of the height of the alveolar bone filling. It was good in 46.6% of the cases, fair in 26.7% and weak in 26.7%. The occlusal score evidenced crossed occlusion in 33.3% of the cases for a hemisection and in 46.7% of the cases for an anterior section. Normal occlusion was achieved in 20%. The quality of palatine repair was found to be good with a normal mucosa in 86.7% of the cases. A fistula was present in 13.3%. CONCLUSION: The preoperative objectives of periosteal graft repair of unilateral complete clefts were achieved. This technique provides a closed scar-free palate. Nasal repair favored the development of an ample and functional airway. The periosteal graft produced bone in the anterior portion allowing a harmonious premaxillary region and stable nose support.

Adolescent↗

PubMed2001

[Orthopedic treatment of labio-maxillo-palatal clefts: our approach].

Many authors use a preliminary orthopedic procedure before cleft lip and palate surgical closure in order to prevent possible bone distortion following the rupture of the muscle belts resulting from the cleft. Actually, this is generally not only an orthopedic treatment but rather a surgical orthopedic step which includes lip adhesion before the surgical closure of the clefts. Following the procedures proposed by Georgiade and Latham, we have used since 1996 a treatment based on traction applied with an elastic chain on splints attached by transmaxillary pins for certain types of clefts, namely unilateral complete clefts with endognathy of the small fragment, unilateral complete clefts larger than 7 mm, bilateral wide complete clefts with premaxilla protrusion, and bilateral wide complete clefts with collapsus and premaxillary protrusion. Technical procedures vary with the type of cleft. Standard procedures with or without jacks are used for the other types of complete clefts. These orthopedic procedures with elastic traction are performed between the 3rd and 6th week, before lip adhesion of the upper part of the lip (combined with release of skin and subcutaneous tissues from the underlying alar cartilage). A palatine plate with or without a jack, fitted most of the time with a spring for nostril support, is then inserted until surgical closure.

Bone Nails↗

PubMed2000

[Facial bone reconstruction. Review of particularities and procedures].

The authors report the particularities of the cranio-maxillofacial skeleton and the aims of the reconstruction procedures: osteogenesis, osteoconduction, osteoinduction. They review the various procedures, their abilities, some technical notes, their advantages and disadvantages. They analyse in order: classical bone autografts, pedicled bone flaps (arterio-osseous, fascio-osseous, myo-osseous flaps), free bone flaps, classical and pedicled periosteal transplantations. They also describe the mechanical and biological procedures of bone stimulation: bone distraction, guided bone regeneration, bone growth factors, and the biomaterials, especially coral and enosseous implants. They conclude that, in facial reconstruction, the best material is the autologous bone membranous and vascularized.

Bone Transplantation↗

PubMed1999

[Surgery of labio-maxillo-palatal clefts during humanitarian mission in the Philippines].

After describing the Philippines and the Comité de Soutien Enfance Philippines, a humanitarian association with a three-fold objective: to build, to educate and to treat, the authors present the organization and practical conduct of their missions abroad which have enabled them to treat almost 400 patients with cleft lip and palate between the ages of 3 months and 46 years.

Adolescent↗

PubMed1999

[The chondrocranium of an 18 mm human embryo. A 3-dimensional computer-assisted reconstruction].

INTRODUCTION: Three-dimensional reconstruction of histologic structures is still a real challenge. This is the reason why very few specimens are published, especially for the head. MATERIAL AND METHODS: The chondrocranium of an 18-mm human embryo was reconstructed from serial histologic sections. The three-dimensional reconstruction was based on a software used in geology and adapted to medical applications. This software was able to smooth the reconstructed model, i.e. to correct the distortions due to the histologic preparation. RESULTS: The chondrocranium model is presented. To facilitate spatial orientation, we added the reconstruction of Merkel cartilage, of Reichert cartilage, of the vertebrae, and of the cerebrum. The different portions of the chondrocranium are described. DISCUSSION: The three-dimensional result is described and advantageously compared to the rare wax models available. The morphological differences are detailed. CONCLUSION: This technique of three-dimensional reconstruction with its smoothing procedure is a very well adapted method for reconstruction of histologic structures. The results presented confirm the educational value of this tool, which is otherwise a powerful instrument of morphogenic study.

Anatomy, Cross-Sectional↗

PubMed1997

Distribution of physicians in Ontario. Where are there too few or too many family physicians and general practitioners?

OBJECTIVE: To assess the regional distribution of family physicians and general practitioners in Ontario after adjusting for practice intensity and the population's patterns of health care use. DESIGN: Analysis of administrative data. SETTING: Ontario. MAIN OUTCOME MEASURES: Intensity of patient use of GP services, GP practice density, and physician density for each Ontario county (measured as the ratio of practice-intensity equivalent GPs to use-intensity equivalent inhabitants). RESULTS: Despite adjustment for practice intensity and use patterns, wide variations exist in GP densities. chi 2 tests identified counties that consistently reported GP densities significantly different (P < 0.001) from the provincial average. Four of the five counties with health science teaching centres had densities significantly higher than the provincial average, while 10 other counties had significantly lower densities. CONCLUSIONS: Results of this study provide useful information for physician resource planning and might inform debate concerning proposals to restrict physician billing numbers and practice locations to rectify perceived maldistribution of physicians.

Adult↗

PubMed1997

[Unusual facial clefts].

After briefly review facial morphogenesis, the authors define facial clefts, distinguishing primary clefts, secondary clefts, and residual clefts. They discuss the uncertainties surrounding the embryology and clinical features of palpebral colobomas. The various pathogenetic concepts are analysed: amniotic hypothesis, vascular hypothesis, fusion defect. The various classifications of rare facial clefts are reviewed, with particular emphasis on Tessier's classification and the so-called Milan classification. The general principles of surgical treatment are described together with the various skeletal and soft tissues procedures.

Craniofacial Abnormalities↗

PubMed1996

[The coral orbital floor. Its value in traumatology. The results of a multicenter study of 83 cases].

A madreporic coral graft was used for orbital floor reconstruction following facial trauma. This report presents a multicentric study of 83 patients with a follow-up period of 15 to 24 months. The results of this study indicate no significant rejection or infection opposed to so many synthetic implants outcome. The radiological follow-up demonstrates a partially resorption of the implant within about 2 years and its replacements by new bone. Coral implant was used to correct enophthalmos or diplopia due to enlarged orbital dimensions. It was technically easy to insert and its anatomic shape does not require to be fashioned before use. Its inflexibility allows to bridge large bone defects and this implant should be considered as an attractive alternative to autogenous grafts, avoiding a second surgical site, in reconstructing orbital floor fractures.

Adolescent↗

PubMed1995

[Surgery and curietherapy of keloids].

Postoperative irradiation of keloids allows a decrease of the recurrence rate by about 50%, compared to surgery alone. A review of the literature illustrates the benefits due to the irradiation, and describes the techniques available. The Iridium 192 interstitial brachytherapy, with per-operative implantation of the plastic tubes and immediate irradiation of 20 Gy at 5 mm depth, is detailed as used by French teams. The analysis of the published results allows to recommend this technique which is tailored to each clinical situation, safe, and easy to perform by the surgeon.

Brachytherapy↗

PubMed1995

[The posterior part of the skull. Classification of dysmorphism. Original treatment: turned biparietal flap transposition].

The deformation of the posterior part of the skull (occipito-vertebral region), induced directly or indirectly, occurs in numerous pathological situations. Its significance is frequently overlooked. Lesions of the cranial content, alterations of the lambdoid suture or other premature synostosis, abnormal constraint related to posture or to muscular activity can modify the posterior curvature of the skull, generally flattening it. The authors propose a classification based on three points: -Intracranial pathology: alterations of the brain or CSF fluid can induce either insufficient (microencephaly) or excessive (hydrocephalus, Dandy Walker or Arnold Chiari malformations) expansion. -Bone pathology: craniosynostosis: sagittal synostosis (scaphocephaly) induces a bulging and coronal synostosis a flatness of the posterior skull. Bilateral premature lambdoid synostosis (pachycephaly) produces total flatness of the back of the skull. -Extrinsic pathology: dysmorphism is often asymmetrical and results from extracranial mechanical application dysfunction such as inborn torticollis, cervical spine pathology (Klippel-Feil syndrome), or prolonged decubitus during the first year of life. The authors describe a personal technique for correcting this dysmorphism: the turned biparietal flap transposition. The back of the skull is remodelled (either asymmetrical or bilateral flatness), and patients with no need for a helmet can lie on their backs immediately after the operation.

Child↗

PubMed1995

[Temporomandibular joint luxation and Ehlers-Danlos disease. Apropos of a case].

First described by Tschernogobow in 1981, Ehlers-Danlos syndrome is usually observed in white males. Symptoms results from defective collagen synthesis. Diagnosis is based on clinical presentation. There are 9 different clinical groups. Maxillofacial manifestations are usually seen in type VIII Ehlers-Danlos syndrome. The clinical case presented here illustrates the problems involving the temporomandibular joints and focuses on an assessment of proposed therapeutic options.

Adolescent↗