scholarly journals Double Rectangle Fascia Lata Frontalis Sling: A Rationale Approach for Ptosis

2021 ◽  
Vol 54 (01) ◽  
pp. 058-062
Author(s):  
Pawan Agarwal ◽  
Dhananjaya Sharma ◽  
Vikesh Agrawal ◽  
Swati Tiwari ◽  
Rajeev Kukrele
Keyword(s):  
Retrospective Study ◽  
Surgical Outcomes ◽  
Functional Outcomes ◽  
Fascia Lata ◽  
Modified Technique ◽  
Eyelid Margin ◽  
Upper Eyelid ◽  
Light Reflex ◽  
Straight Line

AbstractBackground The purpose of this study was to evaluate the functional outcomes of a modified technique of double rectangle pattern for correction of severe ptosis.Methods This is a retrospective study over a period of 8 years including patients who underwent correction of ptosis by double rectangle using autologous fascia lata sling. Surgical outcomes were assessed postoperatively by distance from the corneal light reflex to the upper eyelid margin (MRD1) and levator function.Results Twenty-six eyelids were operated in 20 patients. There were 9 males and 11 females, with age ranging from 4 to 35 years. Preoperatively, all patients had poor MRD1 and poor levator function. Postoperative MRD1 was good in 13 patients (17 eyelids), fair in 5 (7eyelids), and poor in 2 patients (2 eyelids). Postoperative levator function was excellent in 12 patients (15 eyelids), good in 6 (9 eyelids), and fair in 2 patients (2 eyelids). At a mean follow-up of 12 months, adequate correction was achieved in 24 eyelids, and 2 eyelids had undercorrection.Conclusion Frontalis sling with a double rectangle is simple and more efficient, as it provides a straight line of pull to the eyelid for correction of severe ptosis.

scholarly journals Long-term radiological changes and functional outcomes after proximal row carpectomy: Retrospective study with 3 years’ minimum follow-up

2020 ◽  
Vol 106 (8) ◽  
pp. 1589-1595
Author(s):  
Charles Bijon ◽  
Marc Saab ◽  
Thomas Amouyel ◽  
Nadine Sturbois-Nachef ◽  
Elvire Guerre ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Functional Outcomes ◽  
Proximal Row Carpectomy ◽  
Radiological Changes

Clinical Outcomes of Zone 2 Flexor Tendon Repairs Using the Modified Lim/Tsai Technique

2019 ◽  
Vol 24 (01) ◽  
pp. 83-88
Author(s):  
Min Kai Chang ◽  
Sanchalika Acharyya ◽  
Zeus Yiwei Lim ◽  
Shian Chao Tay
Keyword(s):  
Retrospective Study ◽  
Clinical Outcomes ◽  
Flexor Tendon ◽  
Biomechanical Properties ◽  
Modified Technique ◽  
Active Motion ◽  
Satisfactory Outcome ◽  
Flexor Tendon Injuries ◽  
Total Active Motion

Background: The single looped suture modified Lim/Tsai technique is widely used for flexor tendon repairs. It has been shown to possess better biomechanical properties and require less repair time per tendon as compared to the double looped suture original Lim/Tsai technique. However, there is no clinical data on the modified technique. Methods: The retrospective study included zone 2 flexor tendon repairs made using the modified Lim/Tsai technique from January 2008 to December 2014. Clinical outcome was assessed using the revised Strickland and Glogovac criteria, which categorises repairs based on the total active motion of the repaired digit. Results: Sixty-two patients with 74 digits were included. The overall mean total active motion was 122°. The overall satisfactory outcome of the modified Lim/Tsai technique was 81.1%. The rupture rate of the modified Lim/Tsai technique was 2.7%. Using multivariate linear regression model, we found that outcomes were negatively influenced by subzone 2C and crush/saw injuries, but not by concomitant neurovascular injuries or post-operative follow-up duration. Conclusions: Based on this retrospective study of patients with zone 2 flexor tendon injuries, the clinical outcomes of modified and original Lim/Tsai techniques are comparable. As such, there is no clinical evidence favouring one over the other.

scholarly journals Deep Lateral Wall Partial Rim-Sparing Orbital Decompression with Ultrasonic Bone Removal for Treatment of Thyroid-Related Orbitopathy

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Álvaro Bengoa-González ◽  
Alicia Galindo-Ferreiro ◽  
Enrique Mencía-Gutiérrez ◽  
Hortensia Sánchez-Tocino ◽  
Agustín Martín-Clavijo ◽  
...  
Keyword(s):  
Lateral Wall ◽  
Early Postoperative Period ◽  
Ease Of Use ◽  
Decompression Surgery ◽  
Orbital Decompression ◽  
Eyelid Margin ◽  
Upper Eyelid ◽  
Corneal Reflex ◽  
The Mean

Purpose. To describe the results of thyroid-related orbitopathy (TRO) treated by ultrasonic deep lateral wall bony decompression with partial rim sparing (DLW-PRS). Methods. A review was carried out, from January 2015 to September 2017, of all patients treated with ultrasonic DLW-PRS decompression using a SONOPET® (Stryker, Kalamazoo, MI, USA) ultrasonic aspirator, using a lateral, small triangle flap incision for access. The primary outcome was the change in proptosis (measured by the difference in Hertel exophthalmometry measurements). Other secondary outcomes were changes in visual acuity (VA) (using Snellen scale, decimal fraction), presence of lagophthalmos, eyelid retraction (measured by upper eyelid margin distance to the corneal reflex (MRD1) and lower eyelid margin distance to the corneal reflex (MRD2), and presence of exposure keratopathy). Results. A total of 58 orbital decompressions in 35 patients were reviewed, with 23 patients (65.7%) having bilateral decompressions. There was a female preponderance with 26 patients (74.2%), and the mean age ± standard deviation was 52.6 ± 13.9 years. Mean proptosis was 24.51 ± 1.76 mm preoperatively, reduced to 19.61 ± 1.27 mm in final follow-up. The mean reduction was 4.9 ± 1.54 mm. VA improved from 0.8 ± 0.14 to 0.9 ± 0.12, p=0.039. 5 of 13 patients (38.4%) with preoperative diplopia reported improvement or complete resolution after surgery. MRD1 was reduced from 5.25 ± 0.88 mm to 4.49 ± 0.7 mm. MRD2 was also reduced from 6.3 ± 0.88 mm to 5.0 ± 0.17 mm. Presence of lagophthalmos was reduced from 35 eyes (60.3%) to five (8.6%); the presence of epiphora was also reduced from 20 patients (57.1%) to 3 (8.5%) following decompression. Complications of the surgery included zygomatic hypoaesthesia in 14 (40%) patients in the early postoperative period and chewing alterations in 10 (28.5%) of the patients. All of these complications were resolved at the 6-month follow-up visit. We noted no surgical complications such as ocular or soft tissue damage, infection, inflammation, or visual loss. Conclusions. The SONOPET® ultrasonic bone curette can be used safely and effectively for DLW orbital decompression surgery. The main benefits were good visualization and handling of tissues and speed and ease of use of the equipment. This trial is registered with ClinicalTrials.gov identifier: NCT04025034.

scholarly journals Surgical versus Nonsurgical Multimodality Treatment in an Idiopathic Frozen Shoulder: A Retrospective Study of Clinical and Functional Outcomes

2021 ◽  
Vol 10 (21) ◽  
pp. 5185
Author(s):  
Wojciech Satora ◽  
Roman Brzóska ◽  
Robert Prill ◽  
Paweł Reichert ◽  
Łukasz Oleksy ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Functional Outcomes ◽  
Corticosteroid Injection ◽  
Frozen Shoulder ◽  
Post Treatment ◽  
Capsular Release ◽  
Arthroscopic Capsular Release ◽  
Group I ◽  
And Function

This retrospective study compared the clinical and functional outcomes of patients diagnosed with an idiopathic frozen shoulder with symptom onset of a maximum of six months, treated by arthroscopic capsular release followed by corticosteroid injection and physiotherapy to patients who received only corticosteroid injection followed by physiotherapy. The patients who underwent arthroscopic capsular release, intraoperative corticosteroid injection, and physiotherapy (Group I, n = 30) or received only corticosteroids injection and physiotherapy (Group II, n = 29) were examined in terms of shoulder range of motion (ROM), pain intensity, and function before a given treatment and three, six, and twelve months later. The groups were comparable pre-treatment in terms of ROM, pain, and functional outcome. Group I had statistically and clinically significantly better ROM and function at three and six months post-treatment than Group II. Despite being statistically significant, the between-group differences at twelve-month follow-up in ROM and function were too small to be considered clinically notable. The between-group comparison of pain revealed no significant differences at any post-treatment point of time. The early arthroscopic capsular release preceding corticosteroid injection and physiotherapy seemed more effective at three- and six-month follow-up; however, it brought a comparable result to corticosteroid injection and subsequent physiotherapy at twelve months follow-up.

scholarly journals Management of Zygomatico maxillary complex fractures with two-point fixation-A retrospective study for 5 years

2021 ◽  
Vol 12 (1) ◽  
pp. 100-105
Author(s):  
Devakumari Shanmugam ◽  
Vijhayapriya Thanasekaran ◽  
Nandini Biradar ◽  
Amudha Purushothaman ◽  
Dinesh Sridhar ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
Surgical Management ◽  
Bone Fracture ◽  
Surgical Outcomes ◽  
Nasal Bone ◽  
Complex Fractures ◽  
The Face ◽  
Orbital Region

Background: The Zygomatico maxillary complex fractures (ZMC) are commonly encountered in the practice of the maxillofacial surgeon. Perfect management of the fracture is absolutely essential as the revision surgeries are tedious. Surgical management of ZMC is done at two or three points depending on the clinical displacement. Aims and Objectives: Zygomatico maxillary complex is the second most common fractures next to nasal bone fracture in the face worldwide. ZMC fractures are frequently seen and they were managed in great volumes throughout the country. The aim of our study is to prove the surgical outcomes of two-point fixation in the management of ZMC fractures. Materials and Methods: The inpatient records follow up records, radiographic records and photographs of 55 patients who underwent management of ZMC with two point fixations (one at zygomatic buttress and one at the fronto zygomatic region) were retrieved and analysed for the surgical outcomes. The evaluation was done preoperatively and postoperatively at 4weeks, 8 weeks and 12 weeks. Result: Two-point fixations give stable results both aesthetically and functionally in the management of Zygomatico maxillary complex fractures. Conclusion: Rigid internal fixation with titanium miniplates at two points in zygomatic buttress and in the fronto zygomatic region can be adopted with confidence as it gives excellent results. The scar formed in the infraorbital region or the unsightly ectropion can be avoided by not including the infra orbital region.

Successful obliteration of troublesome and chronically draining cavities

2017 ◽  
Vol 131 (2) ◽  
pp. 138-143 ◽  
Author(s):  
S Geerse ◽  
F A Ebbens ◽  
M J F de Wolf ◽  
E van Spronsen
Keyword(s):  
Retrospective Study ◽  
Revision Surgery ◽  
Surgical Outcomes ◽  
Recurrent Disease ◽  
Patient Characteristics ◽  
Surgical Indications ◽  
Mastoid Obliteration ◽  
Total Cohort ◽  
Radical Cavity

AbstractObjective:This study aimed to evaluate the results of revision radical cavity surgery with mastoid obliteration using a standardised grading scheme.Methods:A retrospective study was performed of 121 patients (122 ears) with chronically draining ears who underwent revision radical cavity surgery with mastoid obliteration between 2007 and 2013. Surgical indications, patient characteristics, pre- and post-operative Merchant grade, and surgical outcomes were recorded. The main outcome measures were presence of a dry ear, time for complete re-epithelialisation, presence of residual or recurrent disease, and need for revision surgery.Results:In the 5-year follow-up group (n = 31), dry ears were found in 97 per cent after 6 minor revisions and cholesteatoma-free ears were found in 97 per cent. In the total cohort, dry ears were found in 93 per cent after nine revisions and cholesteatoma-free ears were found in 98 per cent. The median time for complete re-epithelialisation was eight weeks. There were no major complications.Conclusion:In terms of the dry ear rate, residual cholesteatoma and time to complete epithelialisation, revision radical cavity surgery with mastoid obliteration produces very good results in concordance with published results, despite most patients suffering from very troublesome cavities prior to surgery.

scholarly journals Stades method for surgical correction of upper eyelid trichiasis-entropion: results and follow-up in 21 cases

2000 ◽  
Vol 30 (4) ◽  
pp. 651-654
Author(s):  
José Luiz Laus ◽  
Felipe António Mendes Vicenti ◽  
Aline Adriana Bolzan ◽  
Paula Diniz Galera ◽  
Rodrigo Cezar Sanches
Keyword(s):  
Retrospective Study ◽  
Lower Eyelid ◽  
Normal Function ◽  
Surgical Correction ◽  
Upper Eyelid ◽  
Facial Mask ◽  
Maximum Period ◽  
Ocular Signs

Trichiasis is a condition in which lhe cuia and facial hairs grow toward lhe córnea or the conjunctiva. The hairs arising from normal sites are pointed aí an abnormal direction. This condition may be caused by prominent nasal folds, entropion, blepharospasm, slipped facial mask and dermoids. The upper eyelid trichiasis-entropion with lower eyelid entropionectropion frequentiy occurs in oíder English Cocker Spaniels. The ocular signs often are epiphora, blepharospasm, conjunctivitis, keratitis and comeal ulceratíon. Treatment depenas on the severity ofthe condition and must eliminate the ocular contact by misdirected cuia that irritate the eyeball. This report presents a retrospective study of21 patients with bilateral diffüse trichiasis (15 English Cocker Spaniels; 2 Basset hounds; l Bloodhound; l Fila Brasileiro and 2 mongrel dogs). The procedure described by Stades was employed m ali cases. Postoperatively, topical chioramphenicol oiníment (qid) was appiied in the conjunctival soe and on the open woundfor 2 weeks. Sutures were removed 10 days after surgery. Correction ofpositioning ofthe upper eyelid was successfúl and its apposition to córnea was normal. In most of the cases the reepithelialiwtion was complete one month after surgery. No signs ofrecurrence werefound and there appeared to be no loss of normal fünction of the eyelid in the 21 dogs available for follow-up examination in a maximum period of 36 months.

Correction of paralytic lagophthalmos

Folia Medica ◽  
2012 ◽  
Vol 54 (1) ◽  
pp. 24-29
Author(s):  
George E. Anastassov ◽  
Regina H. Khater ◽  
Yourii K. Anastassov
Keyword(s):  
Lower Eyelid ◽  
Technical Note ◽  
Temporalis Muscle ◽  
Temporalis Fascia ◽  
Eyelid Margin ◽  
Upper Eyelid ◽  
Muscle Transfers ◽  
Conchal Cartilage Graft ◽  
Gold Weights

ABSTRACT INTRODUCTION: Bell’s palsy causes lagophthalmos of the involved eyelids. Secondary to the atonicity of the eyelids, xerophthalmia, conjunctivitis and epiphora develops. There are dynamic (muscle transfers) and static (gold weights, tarsorrhaphy) approaches to alleviate these problems. The GOALS of this study are to present a technical note for a surgical method for lengthening the retracted upper eyelid with autogenous temporalis fascia and elevation of the lower eyelid with transplantation of autogenous morselized conchal cartilage graft via standard blepharoplasty incisions. MATERIAL AND METHODS: The proposed technique is illustrated in details with an example of a patient with paralytic lagophtalmos. The 4 years follow up of the case operated by this technique shows a stable occlusion of the eyelids with a lowering of the upper eyelid and elevation of the lower eyelid margin. CONCLUSION: If the paralysis is complete this technique will not accomplish adequate relieve of symptoms. In this cases re-animation of the eyelids with either temporalis muscle transfers or free micro neurovascular muscle transfers are indicated.

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