18 Nonmucosal Grafts: Fat, Muscle, Fascia Lata, and Septal Cartilage

2022 ◽  
2018 ◽  
Vol 80 (01) ◽  
pp. 023-030 ◽  
Author(s):  
Mirjana Pukšec ◽  
Damir Semenski ◽  
Damir Ježek ◽  
Mladen Brnčić ◽  
Sven Karlović ◽  
...  

AbstractThe purpose of our research is to prove that elastic biomechanical characteristics of the temporalis muscle fascia are comparable to those of the fascia lata, which makes the temporalis muscle fascia adequate material for dural reconstruction in the region of the anterior cranial fossa. Fifteen fresh human cadavers, with age range from 33 to 83 years (median age: 64 years; mean age: 64.28 years), were included in the biomechanical study. Biomechanical stretching test with the comparison of elasticity among the tissues of the temporalis muscle fascia, the fascia lata, and the dura was performed. The samples were stretched up to the value of 6% of the total sample length and subsequently were further stretched to the maximum value of force. The value of extension at its elastic limit for the each sample was extrapolated from the force–extension curve and was 6.3% of the total sample length for the fascia lata (stress value of 14.61 MPa), 7.4% for the dura (stress value of 6.91 MPa), and 8% for the temporalis muscle fascia (stress value of 2.09 MPa). The dura and temporalis muscle fascia shared the same biomechanical behavior pattern up to the value of their elastic limit, just opposite to that of the fascia lata, which proved to be the stiffest among the three investigated tissues. There was a statistically significant difference in the extension of the samples at the value of the elastic limit for the fascia lata in comparison to the temporalis muscle fascia and the dura (p = 0.002; Kruskal–Wallis test). Beyond the value of elastic limit, the temporalis muscle fascia proved to be by far the most elastic tissue in comparison to the fascia lata and the dura. The value of extension at its maximum value of force for the each sample was extrapolated from the force–extension curve and was 9.9% of the sample's total length for the dura (stress value of 10.02 MPa), 11.2% for the fascia lata (stress value of 23.03 MPa), and 18.5% (stress value of 3.88 MPa) for the temporalis muscle fascia. There was a statistically significant difference in stress values at the maximum value of force between the dura and the temporalis muscle fascia (p = 0.001; Mann–Whitney U test) and between the dura and the fascia lata (p < 0.001; Mann–Whitney U test). Because of its elasticity and similarity in its mechanical behavior to the dura, the temporalis muscle fascia can be considered the most suitable tissue for dural reconstruction.


2007 ◽  
Vol 177 (4S) ◽  
pp. 424-424
Author(s):  
Hassan A. Abdelbaky ◽  
Mostafa M. Elmissiry ◽  
Gamal M. Ghoniem
Keyword(s):  

1993 ◽  
Vol 06 (02) ◽  
pp. 85-92 ◽  
Author(s):  
G. L. Coetzee

SummaryThe immediate postoperative biomechanical properties of an “underand-over” cranial cruciate ligament (CCL) replacement technique consisting of fascia lata and the lateral onethird of the patellar ligament, were compared with that of a modified intra- and extracapsular “under-and-over-the-top” (UOTT) method. The right CCL in twelve adult dogs was dissected out and replaced with an autograft. The contralateral, intact CCL served as the control. In group A, the graft was secured to the lateral femoral condyle with a spiked washer and screw. In group B the intracapsular graft was secured to the lateral femoro-fabellar ligament, and the remainder to the patellar tendon. Both CCL replacement techniques exhibited a 2.0 ± 0.5 mm anterior drawer immediately after the operation. After skeletonization of the stifles, the length and cross-sectional area of the intact CCL and CCL substitutes were determined. Each bone-ligament unit was tested in linear tension to failure at a fixed distraction rate of 15 mm/s with the stifle in 120° flexion. Data was processed to obtain the corresponding material parameters (modulus, stress and strain in the linear loading region, and energy absorption to maximum load).The immediate postoperative structural and material properties of the “under-and-over” cranial cruciate ligament replacement technique with autogenous fascia lata, were compared to that of a modified intra- and extracapsular “under-and-over-the-top” (UOTT) method. The combined UOT T technique was slightly stronger (6%), but allowed 2.8 ± 0.9 mm more cranial tibial displacement at maximum linear force.


2017 ◽  
Vol 70 (2) ◽  
pp. 151-154
Author(s):  
Gábor Bognár ◽  
Loránd Barabás ◽  
Enikő Tóth ◽  
Andrea Schöller ◽  
Gábor István
Keyword(s):  

Absztrakt Bevezetés: A Poupart-szalag fascia lata felhasználásával végzett rekonstrukcióját ismertetjük. Esetismertetés: Egy 66 éves nőbeteg esetét ismertetjük, akinek anamnézisében kizáródott lágyéksérv műtétje kapcsán szerzett vena femoralis sérülés miatti érsebészeti beavatkozás, majd többszöri rekonstrukciós műtétek szerepelnek. A Poupart-szalag helyreállításakor a fascia lata egy 15 × 3 cm-es csíkját használtuk, amit a spina iliaca anterior superiorra nyeleztünk. Ezt transzponáltuk subcutan tunnelen és varrtuk a tuberculum pubicumhoz, fedve így az iliacalis ereket. A hasfal musculoaponeuroticus részét szabott, 15 × 13 cm-es polipropilén hálóval rekonstruáltuk, amelyet subfascialisan a hasfal izomrétegéhez és a „neo-Poupart-szalaghoz” varrtunk. Megbeszélés: A Poupart-szalag teljes destrukciója ritka, de többszöri műtétet vagy traumát követően kialakulhat. A szalag rekonstrukciójában csak szintetikus háló használata volt ismert. Egy publikáció született autológ szövet és polipropilén háló használatával végzett rekonstrukcióról. Az általunk ismertetett műtéti technika ennek módosítása és első a hazai szakirodalomban. Következtetés: Ez az új technika hasznos eszköze lehet mind a plasztikai, mind a sérvsebészettel foglalkozó általános sebészek armamentáriumának.


2019 ◽  
Vol 9 (1) ◽  
pp. 37-40
Author(s):  
Sonali Uttamrao Landge ◽  
◽  
Prafful V Jatale ◽  
Vilas Kirdak ◽  
Sambhaji Chintale ◽  
...  

1966 ◽  
Vol 118 (3) ◽  
pp. 755-767 ◽  
Author(s):  
Bernard G. Sarnat ◽  
Manuel R. Wexler
Keyword(s):  

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ayman Ali Abdel Fattah ◽  
Abdel Hay Rashad Elasy ◽  
Ahmed Helmy Hoseini ◽  
Tarek Abdel Rahman Abdel Hafez

Abstract Background Repair of a perforated tympanic membrane (myringoplasty) can facilitate normal middle ear function, resist infection, and help re-establish normal hearing. Autogenous graft materials are the most popular graft materials used in myringoplasty because of their easy acceptability by the body. This study is conducted to compare between temporalis fascia graft and fascia lata graft in myringoplasty for patients with tubo-tympanic dry perforation. Results A total of 60 patients with persistent dry tympanic membrane perforation were included in our study during the period from January 2018 to May 2020. Patients underwent myringoplasty with temporalis fascia (30 patients as group A) or fascia lata (30 patients as group B). Patients were scheduled for follow-up visits concerning graft status, ear discharge, and audiograms. The mean postoperative air-bone gap in group A was 17.5 ± 4 after 1 month and 8.6 ± 6.9 after 3 months, while in group B, the mean postoperative air-bone gap was 17.6 ± 4.9 after 1 month and 9.4 ± 7.5 after 3 months. There was 90% success in graft uptake in group A, while there was 80% success in group B. Conclusion Using temporalis fascia is still the best and most trustworthy technique of myringoplasty compared to fascia lata graft. However, fascia lata can be a good alternative to temporalis fascia especially in cases of revision myringoplasty, ears having large perforation, or near-total perforation where the chances of residual perforation are high because of the limited margin of remnant tympanic membrane overlapping the graft.


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