Biomedical subjects

R B Ross

Publications and source records attributed to R B Ross.

36 records · Page 2Linked to original sources

PubMed1985

Classification and treatment of hemifacial microsomia.

On the basis of 37 surgically treated patients with hemifacial microsomia, an anatomical-surgical classification was developed which divides these patients into five categories to facilitate surgical planning and help standardize treatment. Treatment was founded on the cooperation of a large craniofacial team. Osteotomies of the jaws, construction of the TM joint with costochondral grafts, onlay bone grafts, and genioplasty were performed to improve facial form and function. Facial scars were avoided. After three-dimensional skeletal alignment, there was rarely a compelling need for subsequent soft tissue augmentation.

Adult↗

PubMed1984

Delayed hard palate closure: the philosophy revisited.

Delaying surgical closure of the hard palate in children with cleft lip and palate has become increasingly popular. This essay is a review of the rationale and supporting evidence for this procedure, with emphasis on its effect on speech, particularly articulation and velopharyngeal function. We have concluded that the assumptions on which this method is based have never been proven, and that the deleterious effects on speech often noted have not received appropriate attention.

Adolescent↗

PubMed1983

Effect of irradiation on facial growth: a 7- to 25-year follow-up.

This retrospective study is a review of 41 patients who had received irradiation to the head and face during the growth period. Not only is growth of soft tissue and bone of the irradiated area noticeably affected, but other parts of the face can also be involved, especially if the dose is to the upper face and the cranial base. We were able to define a definite cutoff point for a harmful dose for growing facial bones, but the harmful dose for soft tissue could not be determined and may be as low as 400 rads.

Adolescent↗

PubMed1982

Surgical advancement of the retrognathic mandible in growing children.

Orthodontists and surgeons may occasionally decide that there are compelling reasons for correcting a retrognathic mandible surgically before facial growth is completed. The literature implies that there will be no untoward effects. This study on twenty-two growing children demonstrated that there are severe growth disturbances after surgery. The response varied with the amount of surgical correction: Type A cases (those advanced more than 10 mm.) showed either resorption of the condyle, bizarre bony outgrowths in the posterior symphysis, or both. Relapse may continue in these cases for several years. Once condylar resorption occurred, there was no recovery. Type B cases (those advanced less than 9 mm.) had a milder response. Even in Type B cases, however, there was no clinically significant increase in mandibular length subsequent to surgery. There is a one-year recovery period, after which further growth and remodeling of the condyle are directed (if our hypothesis is correct) towards achieving an equilibrium of forces and a return to the preoperative growth pattern. We found that movement of the Y point (intersection of the posterior surface of the symphysis with the inferior border of the mandible) reflected a stable growth pattern prior to surgery and returned to the same pattern, usually within 2 years after surgery.

Adolescent↗

PubMed1981

A comprehensive scoring system for evaluating Noonan syndrome.

A multidisciplinary team assessed 23 patients with various manifestations of the Noonan syndrome, including pulmonary valve stenosis (with leaflet dysplasia), "typical" facial appearance (including hypertelorism, epicanthic folds, flat nasal bridge, and apparently low-set ears), short stature, and mental retardation. Seven patients had a family history of the syndrome. A comprehensive scoring system was devised on the basis of frequency and severity of manifestations and results of invasive and noninvasive tests in these patients and those reported in the literature. The scoring system was condensed into a score card for clinical use and validated by "blind" application to patients with isolated pulmonary valve stenosis or suspected Noonan syndrome. Use of a scoring system to diagnose a syndrome for which there is no specific diagnostic test facilitates accuracy and decreases observer bias. In the case of unusual congenital disorders it is particularly valuable for a pediatrician in general practice.

Adolescent↗

PubMed1980

Articulation before and after facial osteotomy.

We examined the articulation in 41 patients before and after facial osteotomies to correct occlusal defects. Both dental occlusion and articulation improved significantly after surgery. Before surgery there was a direct relationship between the degree of prognathia and the severity of the articulation defect; after surgery in the patients with retrognathia there was a direct relationship between the decrease in the occlusion defect. For other types of occlusal defect these relationship were not established.

Adolescent↗

PubMed1977

Anthropometry of the face in lateral facial dysplasia: the bilateral form.

The morphology of the head, face, and ears was studied in 26 patients with bilateral lateral facial dysplasia in The Hospital for Sick Children, Toronto, using anthropometric and cephalometric methods. The anthropometric data of the maxilla and mandible were compared to the cephalometric findings. The study showed that, in the majority of the patients, one side of the face was more damaged than the other was was associated with a high frequency of defects in all areas of the face. The microtic ear was not necessarily part of this syndrome. The anthropometry proved to be a valuable supplement to the x-ray cephalometry assessment of the malformed face.

Adolescent↗

PubMed1975

The management of dental arch deformity in cleft lip and palate.

Dental arch deformities develop in the embryo and fetus and are severe at birth. The clinician's responsibility to the patient is to guide the natural mechanisms of growth and compensation so that many aspects of the deformities will be alleviated. Scar tissue is an undesirable sequela to surgery, and should ideally not be adjacent to actively growing areas of the maxilla. There are three methods of managing arch deformities: by prevention, by interception, and by correction. The plastic surgeon modifies the deformity and thereby establishes the framework within which the orthodontist and prosthodontist may accomplish fairly minor alterations.

Adolescent↗

PubMed1975