Eric Stelnicki | Cleveland Clinic (original) (raw)
Papers by Eric Stelnicki
International Journal of Oral and Maxillofacial Surgery, Sep 1, 2013
Fracture fixation using adhesive is a promising alternative in craniofacial surgeries, replacing ... more Fracture fixation using adhesive is a promising alternative in craniofacial surgeries, replacing the plates and screws system. The advantages include the ease of application and avoidance of drilling holes that may weaken the bone and cause fractures. In this study the bond strengths of selected adhesives were evaluated and compared with resorbable plates and screws. Four adhesives, octyl-cyanoacrylate, N-butyl-cyanoacrylate, a novel methyl-methacrylate, and a novel cyanoacrylate derivative, were tested for their microtensile and shear bond strengths. The bone samples were cut into rectangular bars and bonded with selected adhesives for microtensile testing. For the shear bond test, paired bars were bonded at the overlap, while two other sets of bars were attached by a Lactosorb plate using either adhesive or screws. Data were analysed by analysis of variance (ANOVA). The microtensile bond strengths of N-butyl-cyanoacrylate, novel cyanoacrylate derivative, and novel methyl-methacrylate derivative were significantly greater than octyl-cyanoacrylate. When bone sections were fixed with resorbable plates and adhesives, shear bond strength was significantly greater for N-butyl-cyanoacrylate than plate and screws, while the bond strengths of other adhesives were comparable with the plate and screws. N-Butyl cyanoacrylate was shown to have the greatest potential for fixation of fractured bone in craniofacial surgical applications.
Plastic and Reconstructive Surgery, Apr 1, 2015
Journal of Craniofacial Surgery, May 1, 1997
A new method has been developed for the closed reduction of minimally displaced, noncomminuted zy... more A new method has been developed for the closed reduction of minimally displaced, noncomminuted zygomatic arch fractures that is minimally invasive and precludes the use of nonresorbable materials such as plates and wires in the repair. Twenty rats received simple, minimally displaced right-sided zygomatic arch fractures under general anesthesia. In 10 animals these fractures were treated with closed reduction through a temporal approach (Gillies method) to reapproximate the fractured segments. In the second group of 10, immediately after the closed fracture reduction, 1 ml of hydroxyapatite cement paste (BoneSource, Leibinger Corp., Dallas, TX) was injected through a 14-gauge needle into and around the fracture site. This paste, which is remodeled into bone over time, hardens into a plaster-like substance within 20 minutes of mixing. The majority of the paste was placed on the medial aspect of the fracture to act as a buttress between the fractured zygoma and the temporalis muscle lying on the greater wing of the sphenoid. This served to support the fracture by "casting" the bone and preventing it from collapsing medially. Nine of the 10 fractures treated with the hydroxyapatite paste healed completely without evidence of zygomatic displacement or malunion. One fracture had mild displacement of the fractured segment but good bone healing between the fractured sides. No adverse effects were noted in the temporalis muscle of these animals, and mastication was normal. Five of the 10 treated with closed reduction alone also had a good result. Of the remaining 5 fractures 2 had a mild to moderate bony deformity as a result of improper alignment during fracture healing. The other 3 did not heal and, therefore, formed a fibrous nonunion at the fracture site. We concluded that closed reduction of simple zygomatic fractures can be performed if the fracture site is held in place with a stabilizing material such as a hydroxyapatite cement paste.
Journal of Craniofacial Surgery, Nov 1, 1997
Journal of Investigative Dermatology, Jul 1, 1998
Plastic and Reconstructive Surgery, Aug 1, 2002
Craniosynostosis is characterized by premature fusion of the cranial sutures. At the molecular le... more Craniosynostosis is characterized by premature fusion of the cranial sutures. At the molecular level, mutations in homeobox genes, transcription factors, and growth factor receptors have been implicated in the pathogenesis of this disorder, but the specific etiologic pathways have not yet been elucidated. To further study the molecular biology behind craniosynostosis, perisutural tissues in a unique rabbit model with congenital delayed-onset coronal craniosynostosis were examined for the presence of the hedgehog family of growth factors and their receptor, patched-1. Expression of desert hedgehog, Indian hedgehog, sonic hedgehog, and patched-1 was evaluated in four areas: suture, endosteum, periosteum, and osteocytes, using immuno-histochemistry (n = 8). Protein levels in affected animals were compared with protein levels in wild-type control rabbits (n = 8). Overall, sonic hedgehog, Indian hedgehog, and patched-1 protein levels were greater in affected animals. Specifically, areas of increased staining were seen along the bony interface of the endosteum and periosteum and in the osteocytes of the synostotic rabbits. Interestingly, in the suture, increased levels of Indian hedgehog and sonic hedgehog, but not patched-1, were seen. There was minimal expression of desert hedgehog in both rabbit types. The increased overall presence of hedgehog and patched-1 proteins in synostotic rabbits may be a reactive change to the disorder or part of the pathogenic process. Although the specific cause cannot be determined from the data, it is clear that the molecular milieu of the cranial sutures in synostotic rabbits is markedly different from that of wild-type rabbits.
PubMed, Jul 1, 1996
The chronic pain syndrome encompassed by the term RSD is poorly understood. The confusion is caus... more The chronic pain syndrome encompassed by the term RSD is poorly understood. The confusion is caused in large part by frequent misdiagnosis and excessive use of sympatholytic procedures in inappropriate circumstances. Recently, pain specialists have redefined the specific criteria for regional pain syndromes having sympathetic maintaining factors, emphasizing application of placebo testing in diagnosis and attention to anatomic principles in pharmacologic and surgical treatment. The authors believe that three-phase bone scanning is a valuable adjunct to clinical judgment in making the proper diagnosis. Current thinking suggests that sympathetic maintained pain exists but that it may comprise only approximately 10% of regional pain cases. Once the appropriate diagnosis is made, classically described sympatholytic procedures are reasonably used. Alternative techniques, such as spinal cord stimulation, may have an important role in refractory cases of sympathetically maintained pain.
Journal of Bioactive and Compatible Polymers, Feb 2, 2012
In this study, the effect of pharmaceutical-grade alginates on the cell viability of human mesenc... more In this study, the effect of pharmaceutical-grade alginates on the cell viability of human mesenchymal stem cells derived from umbilical cord was examined and their use in tissue engineering applications was evaluated. The effects of the ratio of the copolymer building blocks (guluronic and mannuronic acids) and their interactions with divalent calcium, the purity of alginates (proteins and polyphenol content),
The Cleft Palate-Craniofacial Journal, Mar 1, 2006
Objective This report describes an interesting case providing a brief review of the literature an... more Objective This report describes an interesting case providing a brief review of the literature and highlighting the complexity in management and definitive treatment of a premature neonate with an obstructive epignathus teratoma and polydactyly bilaterally. Additionally, this case is unique because of the extremely large size of the oral tumor in relation to the neonate's total body size.
PubMed, Aug 2, 2003
The alignment of the alveolar segments creates the foundation upon which excellent results of lip... more The alignment of the alveolar segments creates the foundation upon which excellent results of lip and primary nasal surgery are dependent in the repair of the cleft lip and palate patient. The purpose of this article is to illustrate the step-by-step fabrication process of the nasoalveolar molding appliance used to direct growth of the alveolar ridge, lips, and nose in the presurgical treatment of cleft lip and palate. As a result of this appliance, the primary surgical repair of the nose and lip heals under minimal tension, thereby reducing scar formation and improving the esthetic result.
ABSTRACT Objective: Retinoic acid (RA) is known to induce osteogenic differentiation in many cell... more ABSTRACT Objective: Retinoic acid (RA) is known to induce osteogenic differentiation in many cell types. Mesenchymal stem cells are being used as promising tool for regenerative therapy. The objective of this study was to investigate the potential of retinoic acid as an inducer of osteogenic differentiation in human umbilical cord derived mesenchymal stem cells (hUMSCs) and its subsequent use in bone tissue engineering for the repair and regeneration of craniofacial bony defects with special emphasis on cleft-palate. Method: The hUMSCs obtained from Sciencell (Carlsbad, CA) were cultured in complete medium containing low glucose Dulbecco’s modified eagle medium with 10% of Fetal Bovine serum and 1% antibiotic and antimycotic solution at 37°C in 5% CO2. Cells with 70-80% confluency, were treated with retinoic acid (0.5, 1 and 2µM) in the presence of complete medium along with ascorbic acid and β glycerophsophate. Cells grown in similar culture conditions in absence of retinoic acid were considered as control. Cell proliferation was measured at 1 day, 2 day and 3 day intervals. On day 7, the expression of osteogenic marker genes was measured by RT-PCR. The activity of alkaline phosphatase (ALP) enzyme was determined using colorimetric assay. Matrix mineralization was assessed on day 21, by alizarin red staining. Result: Cell proliferation was significantly decreased in dose dependent manner in the cells exposed to retinoic acid when compared to control. The ALP gene expression was significantly down regulated by RA in a dose dependent manner. The ALP activity measured on days 7 and 14 also showed a significant decrease in the cells treated with retinoic acid. hUMSCs did not show matrix mineralization. Conclusion: The results of this study suggested that under the above experimental conditions RA may not support osteogenic differentiation of hUMSCs. (Support NSUHPD).
Plastic and Reconstructive Surgery, Apr 1, 2015
Annals of Plastic Surgery, Jun 1, 2018
Journal of Craniofacial Surgery, 2009
Plastic and Reconstructive Surgery, Apr 1, 2015
Annals of Plastic Surgery, Dec 1, 1999
Treatment of the posttraumatic, vertically shortened upper lip is a difficult surgical problem. I... more Treatment of the posttraumatic, vertically shortened upper lip is a difficult surgical problem. It requires careful evaluation of the underlying injury followed by staged therapeutic interventions. Both surgical and nonsurgical treatments need to be employed to optimize results. The authors present three distinct cases of posttraumatic upper lip reconstruction that utilize a variety of treatment modalities. All patients were treated by the senior author.
Atlas of the oral and maxillofacial surgery clinics of North America, Mar 1, 2002
Plastic and Reconstructive Surgery, Apr 1, 2014
A p il 6–8, 2014 CONCLUSION: Although “normal” range of nasal symmetry was documented in some pat... more A p il 6–8, 2014 CONCLUSION: Although “normal” range of nasal symmetry was documented in some patients following cleft lip and nasal repair, most patients with UCLP, regardless of whether or not they had an internal splint, have nasal asymmetry when compared to normal controls. The additional of an internal splint did not improve symmetry. To improve nasal symmetry, revisional operations will be necessary for most children with UCLP. Preoperative 3D photogrammetric evaluation may facilitate tailored surgical intervention to improve symmetry. P4 NonOsteotomy Treatment of Class III Skeletal Malocclusion Using Piriform Plates
Clinics in Plastic Surgery, Jul 1, 1996
The Cleft Palate-Craniofacial Journal, May 1, 2012
Congenital microstomia in the newborn can result in poor functional and aesthetic outcomes. In th... more Congenital microstomia in the newborn can result in poor functional and aesthetic outcomes. In the past, treatment options have included surgical methods such as commissurotomies and z-plasties as well as nonsurgical treatments using oral splints. In severe microstomia, a surgical release may be required to permit splint placement. Because of the small diameter of the stoma, such surgical releases are not optimal and frequently must be repeated. We devised a nonoperative technique for the initial treatment of congenital microstomia that will slowly enlarge the stomal diameter without the need for surgical release. The patient is a newborn male born with multiple congenital anomalies including severe mandibular hypoplasia and retrusion, microstomia, and microglossia. The size of his oral cavity was less than 1 cm at birth with no clinical signs of a tongue. After initial dilation in the operating room with Hagar dilators, the oral stoma was serially dilated using Boston Scientific esophageal balloons. Once full dilation was achieved, we fabricated oral splints to continue the dilation process while maintaining oral competence with no surgical intervention.
International Journal of Oral and Maxillofacial Surgery, Sep 1, 2013
Fracture fixation using adhesive is a promising alternative in craniofacial surgeries, replacing ... more Fracture fixation using adhesive is a promising alternative in craniofacial surgeries, replacing the plates and screws system. The advantages include the ease of application and avoidance of drilling holes that may weaken the bone and cause fractures. In this study the bond strengths of selected adhesives were evaluated and compared with resorbable plates and screws. Four adhesives, octyl-cyanoacrylate, N-butyl-cyanoacrylate, a novel methyl-methacrylate, and a novel cyanoacrylate derivative, were tested for their microtensile and shear bond strengths. The bone samples were cut into rectangular bars and bonded with selected adhesives for microtensile testing. For the shear bond test, paired bars were bonded at the overlap, while two other sets of bars were attached by a Lactosorb plate using either adhesive or screws. Data were analysed by analysis of variance (ANOVA). The microtensile bond strengths of N-butyl-cyanoacrylate, novel cyanoacrylate derivative, and novel methyl-methacrylate derivative were significantly greater than octyl-cyanoacrylate. When bone sections were fixed with resorbable plates and adhesives, shear bond strength was significantly greater for N-butyl-cyanoacrylate than plate and screws, while the bond strengths of other adhesives were comparable with the plate and screws. N-Butyl cyanoacrylate was shown to have the greatest potential for fixation of fractured bone in craniofacial surgical applications.
Plastic and Reconstructive Surgery, Apr 1, 2015
Journal of Craniofacial Surgery, May 1, 1997
A new method has been developed for the closed reduction of minimally displaced, noncomminuted zy... more A new method has been developed for the closed reduction of minimally displaced, noncomminuted zygomatic arch fractures that is minimally invasive and precludes the use of nonresorbable materials such as plates and wires in the repair. Twenty rats received simple, minimally displaced right-sided zygomatic arch fractures under general anesthesia. In 10 animals these fractures were treated with closed reduction through a temporal approach (Gillies method) to reapproximate the fractured segments. In the second group of 10, immediately after the closed fracture reduction, 1 ml of hydroxyapatite cement paste (BoneSource, Leibinger Corp., Dallas, TX) was injected through a 14-gauge needle into and around the fracture site. This paste, which is remodeled into bone over time, hardens into a plaster-like substance within 20 minutes of mixing. The majority of the paste was placed on the medial aspect of the fracture to act as a buttress between the fractured zygoma and the temporalis muscle lying on the greater wing of the sphenoid. This served to support the fracture by "casting" the bone and preventing it from collapsing medially. Nine of the 10 fractures treated with the hydroxyapatite paste healed completely without evidence of zygomatic displacement or malunion. One fracture had mild displacement of the fractured segment but good bone healing between the fractured sides. No adverse effects were noted in the temporalis muscle of these animals, and mastication was normal. Five of the 10 treated with closed reduction alone also had a good result. Of the remaining 5 fractures 2 had a mild to moderate bony deformity as a result of improper alignment during fracture healing. The other 3 did not heal and, therefore, formed a fibrous nonunion at the fracture site. We concluded that closed reduction of simple zygomatic fractures can be performed if the fracture site is held in place with a stabilizing material such as a hydroxyapatite cement paste.
Journal of Craniofacial Surgery, Nov 1, 1997
Journal of Investigative Dermatology, Jul 1, 1998
Plastic and Reconstructive Surgery, Aug 1, 2002
Craniosynostosis is characterized by premature fusion of the cranial sutures. At the molecular le... more Craniosynostosis is characterized by premature fusion of the cranial sutures. At the molecular level, mutations in homeobox genes, transcription factors, and growth factor receptors have been implicated in the pathogenesis of this disorder, but the specific etiologic pathways have not yet been elucidated. To further study the molecular biology behind craniosynostosis, perisutural tissues in a unique rabbit model with congenital delayed-onset coronal craniosynostosis were examined for the presence of the hedgehog family of growth factors and their receptor, patched-1. Expression of desert hedgehog, Indian hedgehog, sonic hedgehog, and patched-1 was evaluated in four areas: suture, endosteum, periosteum, and osteocytes, using immuno-histochemistry (n = 8). Protein levels in affected animals were compared with protein levels in wild-type control rabbits (n = 8). Overall, sonic hedgehog, Indian hedgehog, and patched-1 protein levels were greater in affected animals. Specifically, areas of increased staining were seen along the bony interface of the endosteum and periosteum and in the osteocytes of the synostotic rabbits. Interestingly, in the suture, increased levels of Indian hedgehog and sonic hedgehog, but not patched-1, were seen. There was minimal expression of desert hedgehog in both rabbit types. The increased overall presence of hedgehog and patched-1 proteins in synostotic rabbits may be a reactive change to the disorder or part of the pathogenic process. Although the specific cause cannot be determined from the data, it is clear that the molecular milieu of the cranial sutures in synostotic rabbits is markedly different from that of wild-type rabbits.
PubMed, Jul 1, 1996
The chronic pain syndrome encompassed by the term RSD is poorly understood. The confusion is caus... more The chronic pain syndrome encompassed by the term RSD is poorly understood. The confusion is caused in large part by frequent misdiagnosis and excessive use of sympatholytic procedures in inappropriate circumstances. Recently, pain specialists have redefined the specific criteria for regional pain syndromes having sympathetic maintaining factors, emphasizing application of placebo testing in diagnosis and attention to anatomic principles in pharmacologic and surgical treatment. The authors believe that three-phase bone scanning is a valuable adjunct to clinical judgment in making the proper diagnosis. Current thinking suggests that sympathetic maintained pain exists but that it may comprise only approximately 10% of regional pain cases. Once the appropriate diagnosis is made, classically described sympatholytic procedures are reasonably used. Alternative techniques, such as spinal cord stimulation, may have an important role in refractory cases of sympathetically maintained pain.
Journal of Bioactive and Compatible Polymers, Feb 2, 2012
In this study, the effect of pharmaceutical-grade alginates on the cell viability of human mesenc... more In this study, the effect of pharmaceutical-grade alginates on the cell viability of human mesenchymal stem cells derived from umbilical cord was examined and their use in tissue engineering applications was evaluated. The effects of the ratio of the copolymer building blocks (guluronic and mannuronic acids) and their interactions with divalent calcium, the purity of alginates (proteins and polyphenol content),
The Cleft Palate-Craniofacial Journal, Mar 1, 2006
Objective This report describes an interesting case providing a brief review of the literature an... more Objective This report describes an interesting case providing a brief review of the literature and highlighting the complexity in management and definitive treatment of a premature neonate with an obstructive epignathus teratoma and polydactyly bilaterally. Additionally, this case is unique because of the extremely large size of the oral tumor in relation to the neonate's total body size.
PubMed, Aug 2, 2003
The alignment of the alveolar segments creates the foundation upon which excellent results of lip... more The alignment of the alveolar segments creates the foundation upon which excellent results of lip and primary nasal surgery are dependent in the repair of the cleft lip and palate patient. The purpose of this article is to illustrate the step-by-step fabrication process of the nasoalveolar molding appliance used to direct growth of the alveolar ridge, lips, and nose in the presurgical treatment of cleft lip and palate. As a result of this appliance, the primary surgical repair of the nose and lip heals under minimal tension, thereby reducing scar formation and improving the esthetic result.
ABSTRACT Objective: Retinoic acid (RA) is known to induce osteogenic differentiation in many cell... more ABSTRACT Objective: Retinoic acid (RA) is known to induce osteogenic differentiation in many cell types. Mesenchymal stem cells are being used as promising tool for regenerative therapy. The objective of this study was to investigate the potential of retinoic acid as an inducer of osteogenic differentiation in human umbilical cord derived mesenchymal stem cells (hUMSCs) and its subsequent use in bone tissue engineering for the repair and regeneration of craniofacial bony defects with special emphasis on cleft-palate. Method: The hUMSCs obtained from Sciencell (Carlsbad, CA) were cultured in complete medium containing low glucose Dulbecco’s modified eagle medium with 10% of Fetal Bovine serum and 1% antibiotic and antimycotic solution at 37°C in 5% CO2. Cells with 70-80% confluency, were treated with retinoic acid (0.5, 1 and 2µM) in the presence of complete medium along with ascorbic acid and β glycerophsophate. Cells grown in similar culture conditions in absence of retinoic acid were considered as control. Cell proliferation was measured at 1 day, 2 day and 3 day intervals. On day 7, the expression of osteogenic marker genes was measured by RT-PCR. The activity of alkaline phosphatase (ALP) enzyme was determined using colorimetric assay. Matrix mineralization was assessed on day 21, by alizarin red staining. Result: Cell proliferation was significantly decreased in dose dependent manner in the cells exposed to retinoic acid when compared to control. The ALP gene expression was significantly down regulated by RA in a dose dependent manner. The ALP activity measured on days 7 and 14 also showed a significant decrease in the cells treated with retinoic acid. hUMSCs did not show matrix mineralization. Conclusion: The results of this study suggested that under the above experimental conditions RA may not support osteogenic differentiation of hUMSCs. (Support NSUHPD).
Plastic and Reconstructive Surgery, Apr 1, 2015
Annals of Plastic Surgery, Jun 1, 2018
Journal of Craniofacial Surgery, 2009
Plastic and Reconstructive Surgery, Apr 1, 2015
Annals of Plastic Surgery, Dec 1, 1999
Treatment of the posttraumatic, vertically shortened upper lip is a difficult surgical problem. I... more Treatment of the posttraumatic, vertically shortened upper lip is a difficult surgical problem. It requires careful evaluation of the underlying injury followed by staged therapeutic interventions. Both surgical and nonsurgical treatments need to be employed to optimize results. The authors present three distinct cases of posttraumatic upper lip reconstruction that utilize a variety of treatment modalities. All patients were treated by the senior author.
Atlas of the oral and maxillofacial surgery clinics of North America, Mar 1, 2002
Plastic and Reconstructive Surgery, Apr 1, 2014
A p il 6–8, 2014 CONCLUSION: Although “normal” range of nasal symmetry was documented in some pat... more A p il 6–8, 2014 CONCLUSION: Although “normal” range of nasal symmetry was documented in some patients following cleft lip and nasal repair, most patients with UCLP, regardless of whether or not they had an internal splint, have nasal asymmetry when compared to normal controls. The additional of an internal splint did not improve symmetry. To improve nasal symmetry, revisional operations will be necessary for most children with UCLP. Preoperative 3D photogrammetric evaluation may facilitate tailored surgical intervention to improve symmetry. P4 NonOsteotomy Treatment of Class III Skeletal Malocclusion Using Piriform Plates
Clinics in Plastic Surgery, Jul 1, 1996
The Cleft Palate-Craniofacial Journal, May 1, 2012
Congenital microstomia in the newborn can result in poor functional and aesthetic outcomes. In th... more Congenital microstomia in the newborn can result in poor functional and aesthetic outcomes. In the past, treatment options have included surgical methods such as commissurotomies and z-plasties as well as nonsurgical treatments using oral splints. In severe microstomia, a surgical release may be required to permit splint placement. Because of the small diameter of the stoma, such surgical releases are not optimal and frequently must be repeated. We devised a nonoperative technique for the initial treatment of congenital microstomia that will slowly enlarge the stomal diameter without the need for surgical release. The patient is a newborn male born with multiple congenital anomalies including severe mandibular hypoplasia and retrusion, microstomia, and microglossia. The size of his oral cavity was less than 1 cm at birth with no clinical signs of a tongue. After initial dilation in the operating room with Hagar dilators, the oral stoma was serially dilated using Boston Scientific esophageal balloons. Once full dilation was achieved, we fabricated oral splints to continue the dilation process while maintaining oral competence with no surgical intervention.