Biomedical subjects
Publications and source records attributed to P A Hilger.
In this paper we present our positive experience with use of Aquaplast thermoplastic as a tie-down dressing for securing and maintaining skin grafts in good position against their nutrient recipient beds. This unique polymer is safe to use, simple to apply, and maintains uniform pressure across the entire surface of the skin graft, no matter how contoured the shape of the anatomical region.
Aquaplast thermoplastic (Opti-Mold), a unique moldable "tie-down" dressing, can be heated, shaped, and sutured in place over full-thickness skin grafts. It allows for excellent uniform pressure over a skin graft while also allowing for drainage from the graft bed, and is particularly useful for the contoured surfaces of the nose and ears.
Twelve patients with surgically proven otosclerosis and sensorineural hearing loss were studied with high-resolution computed tomography (CT). The purpose was to identify abnormal bony changes that could be diagnostic of cochlear otosclerosis. Of the 24 temporal bones thus studied, 10 showed positive findings. The findings in our study--as well as those of others--show a pericochlear zone of radiolucency. The precise origin of this is undetermined.
At the University of Minnesota and affiliated hospitals several methods of mandibular reconstruction have been used. From October 1978 through March 1984, 11 patients have undergone reconstruction with the A-O plate technique. These patients had both traumatic and oncologic defects. All patients treated with this technique have achieved a solid mandibular arch. Included is a discussion of the theoretical advantages, preoperative prerequisites, and the operative technique.
Critical analysis of an aesthetic surgeon's presurgical and postsurgical photographs may provide an excellent tool for self-assessment, research, and teaching. Techniques are presented that allowed precise definition by personnel other than the surgeon of each patient's deformities and the effects of surgery on them. Trigonometric formulas were developed and a computer was programmed to use the X and Y coordinates for facial landmarks to perform many calculations providing distances, angles, projections, and rotations relating to the rhinoplastic surgery. Cases are reported showing typical changes and some results not readily apparent in the photographs. Such data provide not only current analysis of individual cases, but they eventually will become a large data base that may be used to select groups of rhinoplastic cases having common degrees of deformity or of postoperative changes.
Two techniques for reconstructing the external auditory canal are presented; to our knowledge they have not been described previously. The first technique can be used for disease that does not affect the conchal bowl. The canal is reconstructed with an inferiorly based conchal bowl flap. A second inferiorly based postauricular flap, tunneled through the conchal cartilage, resurfaces the conchal bowl. The postauricular defect is closed primarily. The second technique can be used for disease affecting the conchal bowl. A posteriorly based flap that includes skin overlying the mastoid and posterior surfaces of the pinna is tunneled through the conchal cartilage and resurfaces the conchal bowl and external auditory canal. The defect on the posterior surface of the pinna is closed with tissue advanced from the anterior surface of the pinna at the conchal bowl-antihelical fold junction. The remainder of the retroauricular defect is closed primarily. The advantages of these techniques over current methods are described and illustrative cases presented.
Forty-five patients were evaluated for reconstruction of the mandible. Thirty-four patients had a particulate cancellous bone and marrow (PCM) crib graft placed. Thirty of 34 were successful at the primary operation producing a success rate of 88%. By using secondary procedures all 33 patients repaired to date have been rehabilitated. A dynamic bendable defect bridging plate with cancellous cortical graft (DBDB plate with CCG) was used in 7 patients, 4 of whom had tumor surgery and 3 of whom were operated on after trauma to the anterior mandible. All 7 cases were successfully rehabilitated in achieving a stable, functioning mandibular arch. An osteomyocutaneous flap was planned to reconstruct the anterior mandible in 4 cases; 1 in this group was not reconstructed. The PCM graft has been our first line approach to the mandibular non-union but with experience we are beginning to rely on the DBDB plate with CCG for large bony defects after both trauma and secondarily after tumor surgery. When indicated, the osteomyocutaneous flap has been eminently successful in restoring function and form in the tumor patient.
Self-heard venous hums have been previously documented and recognized as one cause of audible pulsatile tinnitus. A patient presented with a right internal jugular venous hum causing audible tinnitus and a right sensorineural hearing loss, both of which resolved after high ligation of the right internal jugular vein. We speculate that the hearing loss measured initially was factitious and represented a masking effect due to the venous hum.