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Biomedical subjects

S Taicher

Publications and source records attributed to S Taicher.

At least 55 records · Page 3Linked to original sources
PubMed1996

Changing indications for tracheostomy in maxillofacial trauma.

PURPOSE: Tracheostomy is one of the most common surgical procedures, but not always without complications. The purpose of this article was to reevaluate the indications of maintaining the airway with the use of tracheostomy. MATERIALS AND METHODS: A total of 399 patients with maxillofacial trauma, who were treated in the Maxillofacial Surgery Department from 1985 to 1992, were evaluated for the type of fracture and air-way problems. RESULTS: Out of the 399 patients evaluated, 13 needed a tracheostomy. Of these, 6 had had a cricothyroidotomy on arrival, 3 required tracheostomy because of impending airway obstruction, 3 because of respiratory distress, and 1 due to difficulty in intubation. CONCLUSIONS: The results of this study indicated that surgically securing the airway by tracheostomy should be revised compared to other available methods. In the era of rigid fixation of fractures and the possibility of leaving the patient with an open mouth, it is unnecessary to carry out tracheostomy for securing the airway as frequently as in the past.

Airway Obstruction↗
PubMed1996

Conversion disorder after maxillofacial trauma and surgery.

Three cases of conversion disorder are reported: one after orthognathic surgery and two after facial trauma. Two of the cases involved facial anesthesia and one case involved facial palsy. It was thought to be important to bring this phenomenon to the attention of oral and maxillofacial surgeons, to consider its management, and to define the patients with a high risk of developing conversion disorder. The prognosis is dependent on the circumstances of the onset of the disorder, the premorbid psychologic health of the patient, and how rapidly treatment is prescribed.

Adolescent↗
PubMed1996

Radiologic features of central giant cell granuloma of the jaws.

The radiologic features of central giant cell granuloma (CGCG) have not been clearly defined, and conflicting descriptions appear in the literature. This study analyzes the radiologic and clinical features of 80 cases of CGCG. In nearly 50% of the cases the lesion is located in the posterior area of the jaws, that is, the molar, ramus, and tuberosity, and not in the deciduous teeth-bearing area as was accepted in the past. Only 51% of CGCGs are multilocular, and the frequency of these lesions is significantly higher in the mandible than in the maxilla. The correlation between the lesion's size and its locularity is statistically significant, and larger lesions assume a multilocular appearance. Only 6% of the lesions crossed the midline of the jaws, a feature that was considered in the past as typical for CGCG.

Adolescent↗
PubMed1995

Management of triangular fragments of the inferior border of the mandible.

Twenty-five cases of mandibular fractures with triangular fragments in the lower border were analyzed with respect to mode of treatment and rate of complication by infection. Fragments that remained unexposed and unreduced during treatment of the mandibular fractures were not complicated by infection, whereas about 50% of the fragments that were repositioned and fixed became infected. The study discusses the complexity of the physiopathology and management of these fragments. It appears that triangular fragments should be left unexposed.

Fracture Fixation, Internal↗
PubMed1994

Location of the mandibular foramen in panoramic radiographs.

The reliability of two panoramic x-ray machines (Philips Orthoralix SD Ceph and Gendex Panelipse II) for determination of the location of the mandibular foramen was studied with the use of human dry mandibles. A significant correlation was found between the location of the mandibular foramen in the radiograph and the narrowest anteroposterior dimension of the ramus. A linear logistic regression equation was developed that could predict the actual location of the mandibular foramen from the radiographs. This finding will improve treatment planning of surgical splitting or fracturing of the ramus in cases that require orthognathic surgery provided the surgeon is aware of which panoramic machine was used. The Philips Orthoralix SD was found to be more reliable for this purpose than the Panelipse II (R2 = 0.94 and R2 = 0.87, respectively, in the vertical dimension and R2 = 0.87 and R2 = 0.75, respectively, in the horizontal dimension.

Humans↗
PubMed1993

Radiologic features of desmoplastic variant of ameloblastoma.

Desmoplastic variant of ameloblastoma is a newly described variant characterized by unique histologic and radiographic features. This study reviews and analyzes the clinical and radiographic features of 15 cases of desmoplastic variant of ameloblastoma (14 cases from the literature and one case from our files). Desmoplastic variant of ameloblastoma shows a predilection for the maxilla and has a tendency to occur in the anterior region of the mandible and maxilla. Radiographically, almost all desmoplastic variant of ameloblastomas exhibit a mixed radiolucent-radiopaque appearance. Most show poorly defined or diffused borders and are mistakenly diagnosed as fibro-osseous lesions.

Adult↗
PubMed1993

Recovery of the infraorbital nerve after zygomatic complex fractures: a preliminary study of different treatment methods.

The infraorbital nerve (ION) is often involved in trauma to the zygomatic complex (ZC), resulting in sensory disturbance of the area innervated by it. The purpose of the study was to compare the incidence of persistent sensory disturbance after recovery from isolated simple fractures of the ZC, with four treatment methods: 1) closed reduction via subcutaneous approach without fixation; 2) open reduction via subcutaneous approach without fixation; 3) open reduction via oroantral approach and support of the complex by an intraantral Foley catheter; and 4) open reduction via Gillies approach with fixation of the frontozygomatic (FZ) fracture with wire osteosynthesis, and open reduction via Gillies approach with fixation of the FZ fracture with miniplate osteosynthesis. Analysis revealed that patients treated with miniplate osteosynthesis exhibited a trend for higher recovery rate of the (ION) than with the other three methods. No significant differences were found among the other three methods.

Bone Plates↗
PubMed1993

Comparative evaluation of different radiographic projections of zygomatic complex fractures.

Diagnosis of zygomaticomaxillary fractures is a major problem in radiographic interpretation. The purpose of the present study was to evaluate several radiographic examinations performed in an emergency room to diagnose zygomatic complex (ZC) fractures, in order to determine which is the single best radiographic projection for this purpose. Radiographs of 160 patients with ZC fractures were evaluated retrospectively. The modified P-A projection (10 degrees-20 degrees) provided a clear image of the frontozygomatic, infra-orbital rim and temporozygomatic fracture lines in all cases. In half the cases, the modified P-A projection also clearly demonstrated the fracture line in the zygomatic maxillary buttress. On the other hand, the Water's view demonstrated the fracture line in the zygomatic maxillary buttress and the temporozygomatic bone in all cases, but in only 65% of the cases was the fracture line in the infra-orbital rim and the frontozygomatic bones shown. The modified P-A projection was found to be the single best radiographic examination that should be performed in the emergency room to diagnose ZC fractures.

Evaluation Studies as Topic↗
PubMed1993

Life-threatening bleeding following maxillofacial trauma.

Life-threatening bleeding associated with facial trauma is considered rare, and most references on this subject do not recommend a precise treatment plan. The purpose of the present study is to review the origin of bleeding and various treatment methods, and to formulate a plan of management for these patients, emphasizing the role of the maxillofacial surgeon in the immediate intervention to control the bleeding. 222 patients with midface fractures were treated between 1985 to 1990. 10 of them had severe and life-threatening bleeding on admission. Bleeding was controlled by nasal packing (9 patients) combined with temporary fracture reduction (7 patients).

Facial Bones↗
PubMed1992

[Management of fractures of the face].

During 1985-1989, 371 patients with fractures of the lower two thirds of the facial skeleton were treated. Mean age was 31.2 years and there was a male prevalence of 78%. An equal distribution was found between fractures of the middle and lower third of the face. Our clinical experience has shown that it is preferable to start treatment as early as possible, using an open approach for reduction of fractures and rigid methods of fixation. Rigid internal fixation enables the patient to keep his jaws functional postoperatively and prevents the need for maxillomandibular fixation for 6 weeks. 6-month follow-up showed a low incidence of bone infection (1.5%), although most fractures were exposed to contaminated spaces. The major complication of treatment was impaired sensation of the lips and infraorbital regions (23%). In a follow-up of up to 1 year, the occurrence of this complication decreased to 7%.

Adult↗