Craniofacial fractures and brain injuries.
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Biomedical subjects
Publications and source records attributed to M Stricker.
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The authors report two new cases of craniofacial lesions due to the explosion of grindstone wheels and consider, after a short technological introduction, the specific features of these lesions diagnostically and therapeutically. These wheels are subject to mechanical shocks, may be run too fast for their capabilities, and may become overheated during use. In explosions, fragments may penetrate deeply, and are frequently small and difficult to see on X-rays because they are not very radio-opaque. Prevention of these injuries is most important: when they happen, surgeons must search carefully for all fragments.
A method for reconstruction of temporomandibular joint is proposed using an intermediary prosthesis and non-sealed cupula. This prosthesis respects the cranial articular slope and provides twofold mobility at the cupular level, which approaches physiological conditions and allows reproduction of buccal opening and closing movements as well as lateralization. A strict surgical procedure is essential when inserting the prosthesis, particular care being necessary in the approach to the facial nerve and control of its temporofacial contingent until above the zygomatic arch. Indications for this procedure are discussed in relation to injuries and tumoral, degenerative and malformatory lesions.
Pierre Robin syndrome continuously raises problems of intensive care that are difficult to surmount. A peak has to be overcome, the date of which varies as a function of the severity of the affection, following which the infant remains a neonate at high risk. Intensive care of these infants during the neonatal period involves avoidance of the sequence of disturbances provoked by the disorders of ventilation and deglutition. Surveillance of biological variables, feeding and the fight against glossoptosis are mainly the concern of medical procedures: from orthostatic nipples to continuous gastric feeding, from procubitus to intubation with assisted ventilation, and including pharyngeal catheters and physiotherapy. Surgery is required only exceptionally at this stage, mainly in the form of hyomandibulopexy.
The authors describe a child who presented multiple congenital malformations affecting the cranio-facial region and the extremities associated with a rare skin lesion (incontinentia pigmenti achromians).
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The authors describe the microradiographical and histological aspects of ill sutures in cases of trigonocephalies, brachycephalies and oxycephalies. This is based on the study of fragments coming from 30 cases of craniostenosis. They question the responsibility of the dura mater and invoke an encephalic cause producing by error forces at the level of the sutural areas. They also stress the absence of chondroid tissue at this particular level.
A new classification of malformations of the face and cranium is proposed, based on embryologic studies and observations concerning a great number of patients seen by the authors. First of all, one should distinguish between cerebral craniofacial (with brain and/or eyes involved) and craniofacial malformations. Craniofacial malformations may be characterized by dysostosis and by synostosis. Malformations with dysostosis may be produced by transformation as well as differentiation defects. Synostosis is always caused by a differentiation defect. A new nomenclature is introduced.
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The principal general characteristics of musculocutaneous flaps are described. Originally indicated for repair of wounds and reconstructive surgery following operation for cancer, they are now employed to treat post-radiotherapy lesions, burn sequelae, and even facial asymmetry. The principal clinical features of the most commonly applied flaps are discussed with a view to defining their maxillofacial applications more precisely.
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