A CASE OF FUNGUS HÆMATODES, IN A PATIENT SIX YEARS OF AGE, DEVELOPED IN A SUBCUTANEOUS LYMPHATIC GLAND ON THE MARGIN OF THE TEMPORAL FASCIA.

Musculoskeletal pain is often associated with pain referred to adjacent areas or skin. So far, no study has analyzed the somatosensory changes of the skin after the stimulation of different underlying fasciae. The current study aimed to investigate heterotopic somatosensory crosstalk between deep tissue (muscle or fascia) and superficial tissue (skin) using two established models of deep tissue pain (namely focal high frequency electrical stimulation (HFS) (100 pulses of constant current electrical stimulation at 10× detection threshold) or the injection of hypertonic saline in stimulus locations as verified using ultrasound). In a methodological pilot experiment in the TLF, different injection volumes of hypertonic saline (50–800 µL) revealed that small injection volumes were most suitable, as they elicited sufficient pain but avoided the complication of the numbing pinprick sensitivity encountered after the injection of a very large volume (800 µL), particularly following muscle injections. The testing of fascia at different body sites revealed that 100 µL of hypertonic saline in the temporal fascia and TLF elicited significant pinprick hyperalgesia in the overlying skin (–26.2% and –23.5% adjusted threshold reduction, p < 0.001 and p < 0.05, respectively), but not the trapezius fascia or iliotibial band. Notably, both estimates of hyperalgesia were significantly correlated (r = 0.61, p < 0.005). Comprehensive somatosensory testing (DFNS standard) revealed that no test parameter was changed significantly following electrical HFS. The experiments demonstrated that fascia stimulation at a sufficient stimulus intensity elicited significant across-tissue facilitation to pinprick stimulation (referred hyperalgesia), a hallmark sign of nociceptive central sensitization.

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Rhinoplasty: Aesthetic Augmentation With Improvement of Dorsal Aesthetic Lines

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa345 ◽

2021 ◽

Author(s):

Vitaly Zholtikov ◽

Vladimir Golovatinskii ◽

Riadh Ouerghi ◽

Rollin K Daniel

Keyword(s):

Single Layer ◽

Essential Elements ◽

Rectus Abdominis ◽

Nasal Dorsum ◽

Wide Spread ◽

Temporalis Fascia ◽

Temporal Fascia ◽

Layer 2 ◽

Diced Cartilage

Abstract Background Camouflage of nasal dorsum, aesthetic augmentation and highlighting the dorsal aesthetic lines are essential elements in modern rhinoplasty. Numerous techniques have been utilized including deep temporal fascia, rectus abdominis fascia, and diced cartilage in fascia (DC-F). Despite their wide spread adoption, technical challenges remained, especially when utilized for aesthetic purposes. Objectives The paper details the use of fascia (F) and diced cartilage in fascia grafts (DC-F) for aesthetic dorsal refinement in primary and secondary cases. One of the main goals was to achieve ideal dorsal aesthetic dorsal lines rather than just volume augmentation. Methods We used grafts from the deep temporalis fascia (F) and rectus abdominis fascia (RF) in 4 configurations: 1) single layer, 2) double layer, 3) full length diced cartilage in fascia grafts (DC-F), and 4) partially filled – segmental DC-F grafts. Technical refinements included careful determination of dimensions and meticulously suturing to the dorsum at appropriately 10 points to prevent graft displacement. Results We report our experience: 146 clinical cases over 35 months from January 2017 to December 2019. The patients were divided for 4 groups depending on which type of graft was used. Conclusions Use of autogenous deep temporal fascia, rectus abdominis fascia, and diced cartilage in fascia (DC-F) to camouflage dorsal irregularities, to highlight dorsal aesthetic lines, and to aesthetically augment either the entire nasal dorsum or its individual parts. Optimization of cutting, stitching, filling the graft, careful fixation of these grafts on the nasal dorsum, significantly increases the predictability of these techniques and minimizes problems.

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19. Hypertrophy of the Lymphatic Gland in an Adult

The American Journal of the Medical Sciences ◽

10.1097/00000441-184510000-00047 ◽

1845 ◽

Vol 20 ◽

pp. 445

Author(s):

&NA;

Keyword(s):

Lymphatic Gland

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Microvascular Compressicaude by Slinging a Tortuous Vertebrobasilar Artery to the Petrous Dura in Hemifacial Spasm: Technical Note

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0038-1675764 ◽

2018 ◽

Vol 37 (04) ◽

pp. 352-361

Author(s):

Forhad Chowdhury ◽

Mohammod Haque ◽

Jalal Rumi ◽

Monir Reza

Keyword(s):

Vertebral Artery ◽

Free Flap ◽

Hemifacial Spasm ◽

Technical Note ◽

Taxi Driver ◽

Treatment Technique ◽

Entry Zone ◽

Temporal Fascia ◽

Vertebrobasilar Artery ◽

The Brain

Objective In cases of hemifacial spasm caused by a tortuous vertebrobasilar artery (TVBA), the traditional treatment technique involves Teflon (polytetrafluoroethylene), which can be ineffective and fraught with recurrence and neurological complications. In such cases, there are various techniques of arteriopexy using adhesive compositions, ‘suspending loops’ made of synthetic materials, dural or fascial flaps, surgical sutures passed around or through the vascular adventitia, as well as fenestrated aneurysmal clips. In the present paper, we describe a new technique of slinging the vertebral artery (VA) to the petrous dura for microvascular decompression (MVD) in a patient with hemifacial spasm caused by a TVBA. Method A 50-year-old taxi driver presented with a left-sided severe hemifacial spasm. A magnetic resonance imaging (MRI) scan of the brain showed a large tortuous left-sided vertebral artery impinging and compressing the exit/entry zone of the 7th and 8th nerve complex. After a craniotomy, a TVBA was found impinging and compressing the entry zone of the 7th and 8th nerve complex. Arachnoid bands attaching the artery to the nerve complex and the pons were released by sharp microdissection. Through the upper part of the incision, a 2.5 × 1 cm temporal fascia free flap was harvested. After the fixation of the free flap, a 6–0 prolene suture was passed through its length several times using the traditional Bengali sewing and stitching techniques to make embroidered quilts called Nakshi katha. The ‘prolenated’ fascia was passed around the compressing portion of the VA. Both ends of the fascia were brought together and stitched to the posterior petrous dura to keep the TVBA away from the 7th and 8th nerves and the pons. Result The patient had no hemifacial spasm immediately after the recovery from the anesthesia. A postoperative MRI of the brain showed that the VA was away from the entry zone of the 7th and 8th nerves. Conclusion The ‘prolenated’ temporal fascia slinging technique may be a very good option of MVD in cases in which the causative vessel is a TVBA.

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MEDIASTINAL LYMPHATIC GLAND TUBERCULOSIS IN IMMIGRANTS

The Lancet ◽

10.1016/s0140-6736(61)92038-4 ◽

1961 ◽

Vol 277 (7191) ◽

pp. 1405

Author(s):

Norman Macdonald ◽

H.L. Khanchandani

Keyword(s):

Lymphatic Gland

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Comparison of conventional temporalis fascia myringoplasty with fascia lata myringoplasty among patients with hearing loss

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192706 ◽

2019 ◽

Vol 5 (4) ◽

pp. 926

Author(s):

Sumeer Verma ◽

Anshu Arora ◽

Ved Prakash Narvey

Keyword(s):

Postoperative Complications ◽

Biological Properties ◽

Fascia Lata ◽

Graft Material ◽

Hearing Improvement ◽

Temporalis Fascia ◽

Probability Of Survival ◽

Temporal Fascia ◽

Tissue Factors ◽

Tube Function

Background: In selection of a graft tissue factors considered include its biological properties, probability of survival, its adequacy in size and ease of procurement The present study aims to preoperatively predict hearing improvement by paper patch test and compare with postoperative hearing improvement i.e. pre and post operatively hearing assessment.Methods: The study was conducted on 25 cases undergoing myringoplasty with Fascia lata and Temporalis fascia as a graft material among the patients fulfilling the standard criteria for myringoplasty i.e. pars tensa perforation, good cochlear reserve, dry ear and normal eustachian tube function were considered for surgery. Myringoplasty was done from post aural route for harvesting fascia temporalis graft & from upper 1/3rd of thigh laterally to harvest fascia lata. Each case was followed up post operatively monthly for 3 months. Results: Factors which influence graft take up are the size of perforation and lack of infection at the time of surgery and postoperative. Large perforations were difficult to repair as it took more time to heal. Surgery performed postaurally underlay technique using temporal fascia was associated with less morbidity, better uptake and lesser postoperative complications but permeatal route also serve similar purpose and does not affect the result of study significantly.Conclusions: This study compared both temporal fascia and fascia lata as graft materials for myringoplasty and proved that myringoplasty done by postaural underlay technique using temporal fascia holds best as per graft uptake, hearing improvement and postoperative complications when compared to fascia lata myringoplasty.

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Application of fascia of the temporal muscle and cartilage of the auricular tragus in myringoplasty in children

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1208408b ◽

2012 ◽

Vol 140 (7-8) ◽

pp. 408-411 ◽

Cited By ~ 1

Author(s):

Ivan Baljosevic ◽

Jovica Milovanovic ◽

Vladan Subarevic ◽

Mladen Novkovic ◽

Katarina Stankovic

Keyword(s):

Surgical Technique ◽

Tympanic Membrane ◽

Statistical Significance ◽

Functional Results ◽

Young Age ◽

Temporal Muscle ◽

Temporal Fascia ◽

Middle Ear Infection ◽

Number Of Patients ◽

And Cartilage

Introduction. Perforation of the tympanic membrane in children may be the cause of recurrent middle ear infection and loss of hearing. Objective. The aim of this study was to analyze the application of different reconstructive materials in surgical technique myringoplasty. Methods. We performed 88 myringoplasties due to auricular tragus perforation in 76 children (aged 4 to 16 years, mean 11.9 years) from July 2001 to July 2009. Age, gender, size and the site of perforation, status of the contra lateral ear, underlying cause of the perforations, surgical technique, preoperative and postoperative hearing levels and postoperative complications were recorded and analyzed. In performing myringoplasty we used fascia of the temporal muscle and cartilage of the auricular tragus. Results. In 43 (48%) patients we used fascia of the temporal muscle and in 45 (52%) cartilage of the auricular tragus. Graft success was defined as an intact eardrum at 12 months postoperatively and improvement in the perception of air-bone gap of 10 dB, which we recorded in 73 (83%) cases. Re-perforations were recorded in 12 (13%) patients, of whom in 8 (18.6%) cases we used the temporal fascia and in 4 (9.3%) cases a tragal cartilage. Retraction of the tympanic membrane was recorded in 3 (4%) cases with the temporal fascia. Conclusion. Myringoplasty is a reasonably successful method with good functional results in pediatric patients. Risk factors of surgical failure are young age, the size of auricular tragus perforation and pathological conditions of the contra lateral ear. The tragal cartilage gives better results in cases with bilateral perforations because the possibility of retractions and re-perforations is lower. Relatively small number of patients is probably the reason that, except for young age, differences between the two groups did not reach the level of statistical significance.

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