scholarly journals Vertical-to-Horizontal Rotational Myocutaneous Flap for Repairing Cicatricial Lower Lid Ectropion: A Novel Surgical Technique

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Yu-Fan Chang ◽  
Chieh-Chih Tsai ◽  
Hui-Chuan Kau ◽  
Catherine Jui-Ling Liu
Keyword(s):  
Surgical Technique ◽  
Myocutaneous Flap ◽  
Lower Eyelid ◽  
Functional Improvement ◽  
Cosmetic Appearance ◽  
Flap Procedure ◽  
Free Skin Graft ◽  
Cicatricial Ectropion ◽  
Horizontal Eyelid Laxity

Objective. To evaluate the efficacy and complications of a novel surgical technique for cicatricial lower lid ectropion that uses a vertical-to-horizontal (V-to-H) rotational myocutaneous flap procedure (Tsai procedure). Methods. We performed the V-to-H rotational myocutaneous flap procedure on 20 eyelids in 20 patients with mild to moderate cicatricial lower lid ectropion. A vertical myocutaneous flap was created from the anterior lamella of the vertical pedicle in the lateral third of the lower eyelid. Following a horizontal relaxing incision from the base of the flap, a vertical myocutaneous flap was created and rotated to horizontal. Two patients with combined cicatricial ectropion and paralytic lagophthalmos simultaneously underwent additional lateral tarsorrhaphy. Results. After a minimum follow-up period of 6 months, all patients showed good anatomical and functional improvement with decreased dependence on topical lubricants and a satisfactory cosmetic appearance. Two patients with combined cicatricial and paralytic ectropion had mild residual asymptomatic lagophthalmos. No patients required further revision surgery and there were no complications or recurrence. Conclusion. The V-to-H rotational myocutaneous flap technique was an effective and simple one-stage procedure for correcting cicatricial lower lid ectropion. It lengthened the anterior lamella and tightened horizontal eyelid laxity without the need for a free skin graft.

Lateral tarsal strip through osteotomies for recurrent ectropion and eyelid laxity correction

2022 ◽  
pp. 112067212110730
Author(s):  
Amparo M Mora ◽  
Carlos M Córdoba ◽  
Fabio D Padilla ◽  
Diego F Duran
Keyword(s):  
Surgical Technique ◽  
Facial Asymmetry ◽  
Lower Eyelid ◽  
Body Sensation ◽  
Alternative Treatment Option ◽  
Initial Symptoms ◽  
Aesthetic Results ◽  
Lateral Tarsal Strip ◽  
Anophthalmic Socket

Objective to present a surgical technique for treating patients with recurrent ectropion and severe lower eyelid laxity. Methods Lateral tarsal strip and canthal fixation by osteotomy was performed in 6 patients with recurrent ectropion and 1 patient with extreme lower eyelid laxity secondary to an anophthalmic socket. Preoperative and postoperative photographs were evaluated in order to assess the outcomes of the procedure. Patients were followed up 4 weeks, 6 months, 12 months and 24 months of the postoperative period. The initial symptoms of the patients were eye redness, epiphora, foreign body sensation, aesthetic complaints, and facial asymmetry. Symptoms and aesthetic results were assessed by questioning, photographs, and fluorescein and lissamine green stains taken in each visit. Results No postoperative complications were observed. No recurrence episodes were reported during the follow-up period and physical appearance improvement and symptom severity reduction were maintained during the observation. Conclusion Lateral tarsal strip through osteotomies is an effective surgical procedure for treating severe recurrent ectropion cases or lower eyelid laxity and could be considered as an alternative treatment option or even a primary surgical technique in selected difficult cases.

scholarly journals HIGH DEGREE SPONDYLOLISTHESIS IN ADULTS: MONOSEGMENTAL REDUCTION AND FIXATION

2015 ◽  
Vol 14 (3) ◽  
pp. 194-197
Author(s):  
Eduardo Henrique Chiovato Abdala ◽  
Ériko Gonçalves Filgueira ◽  
Luciano de Almeida Ferrer ◽  
João de Souza Nascimento Filho
Keyword(s):  
Surgical Technique ◽  
Conservative Treatment ◽  
Good Control ◽  
Functional Improvement ◽  
Slip Angle ◽  
Partial Reduction ◽  
Adjacent Level ◽  
Neurological Damage ◽  
High Degree

Objective:To evaluate a method to reduce high degree spondylolisthesis in adults with monosegmental fixing preserving the adjacent level and the improvement of sagittal balance.Methods:A prospective study, with 12 adult patients with high degree spondylolisthesis (III and IV) in adults who underwent surgery by the same team. We included 7 women and 5 men with a mean age of 37 years and lombosciatalgy that had no improvement with conservative treatment. The surgical technique used was total or partial reduction by Spondylolisthesis Reduction Instrument (SRI) system, with instrumentation only in the affected level, thus sparing the adjacent level, associated with 360ofusion.Results:The L5-S1 level was involved in nine patients, L4-L5 in two, and VT-S1 in one patient. The isthmic type predominated in nine patients, followed by dysplastic type in two, and one iatrogenic spondylolisthesis. These patients were assessed by the Oswestry scale, which showed a preoperative average of 59% and postoperative average of 12.4% (P<0.05). A significant improvement in the average slip angle from 54.66% to 9.5% (35% to 0%) was found. No major complications such as infection, neurological damage or material breaks were observed.Conclusion:The reduction of high degree listhesis instrumenting only the affected level produces good results, with good control of pain and functional improvement of patients. However, a larger follow-up is required to better evaluation.

scholarly journals Modified everting sutures combined with reattachment to the inferior tarsal plate for involutional lower eyelid entropion: A new technique

2020 ◽  
Vol 47 (4) ◽  
pp. 347-353
Author(s):  
Emine Malkoc Sen ◽  
Kubra Ozdemir Yalcinsoy
Keyword(s):  
Recurrence Rate ◽  
Intraoperative Complications ◽  
Case Series ◽  
Lower Eyelid ◽  
New Technique ◽  
Before And After ◽  
A New Technique ◽  
The Right ◽  
Horizontal Eyelid Laxity

Background This study evaluated the outcomes of a new modified Wies technique for patients with involutional lower eyelid entropion without horizontal eyelid laxity.Methods This case series retrospectively analyzed consecutive patients with entropion who underwent surgery between January 2014 and March 2019 by the same experienced surgeon. Horizontal eyelid laxity, lower eyelid retractor function, and orbicularis muscle overriding were recorded before and after surgery. The recurrence rate and complications were also evaluated. This technique consisted of modified everting sutures combined with reattachment of the lower eyelid retractors to the inferior tarsal plate.Results This new technique was performed on 28 eyes in 25 patients (mean age, 71.0±8.0 years; range, 56–87 years). Nine patients (36%) were women and 16 (64%) were men. Lower lid entropion was present in the right eye in 14 patients (56%), the left eye in eight patients (32%), and both eyes in three patients (12%). The mean follow-up period was 27.3±12.4 months (range, 6–60 months). No intraoperative complications were observed. All patients’ symptoms were alleviated. One patient (3.6%) had recurrence after 2 years (success rate, 96.4%). The remaining 27 eyes maintained a satisfactory and comfortable eyelid position. No patients had problems with scarring.Conclusions The approach described herein proved to be safe and feasible in eyes with involutional lower eyelid entropion without horizontal eyelid laxity. These advantages of this procedure include the lack of a conjunctival scar, punctal eversion, and lateral canthal angle deformation. A low recurrence rate and a long interval to recurrence were also observed.

Pilonidal sinus disease: Karydakis flap procedure in our patients

2020 ◽  
Vol 99 (8) ◽  
Keyword(s):  
Wound Healing ◽  
Pilonidal Sinus ◽  
Healing Process ◽  
Pilonidal Sinus Disease ◽  
Wound Complications ◽  
Limberg Flap ◽  
New Disease ◽  
Sinus Disease ◽  
Flap Procedure

Introduction: Despite the available guidelines, opinions of many surgeons are quite ambiguous when it comes to the therapy of pilonidal sinus disease. The treatment can be a frustrating problem both for the surgeon and the patient because it is associated with wound complications and high recurrence rate. The objective of this study was to analyze the results of patients with pilonidal sinus disease undergoing the Karydakis flap procedure. Methods: A total of 27 patients treated for primary and recurrent pilonidal disease using the Karydakis flap procedure at our department between October 23, 2018 and November 22, 2019 were analyzed prospectively. We evaluated postoperative wound healing, complications and recurrence of the disease in a short-term follow-up period. Disease recurrence was defined as prolonged healing or as a new disease requiring repeated surgery. Results: In December 2019 all 27 patients came for a follow-up visit. The result was a fully lateralized wound without any signs of a new disease in all patients. In May 2020 a follow-up visit by phone was performed. The median follow-up was 12 months. The healing process was free of any serious complications in 25 patients. Seroma formation cases were managed by puncture in the outpatient setting. Conclusion: According to the available evidence and guidelines, off-midline procedures – the Karydakis flap, Bascom cleft lift, and Limberg flap procedures – are associated with lower recurrence rates and better wound healing. An important goal is to achieve complete wound lateralization and to change the configuration of the gluteal cleft by reshaping it, which results in a nicely flattened gluteal crease.

RESULTS OF INTRALESIONAL TRIAMCINOLONE ACETONIDE FOR CHALAZION TREATMENT

2011 ◽  
pp. 100-104
Author(s):  
Thi Thu Nguyen ◽  
Viet Hien Vo ◽  
Thi Em Do
Keyword(s):  
Success Rate ◽  
Key Words ◽  
Triamcinolone Acetonide ◽  
Lower Eyelid ◽  
Upper Eyelid ◽  
Interventional Trial ◽  
The Mean ◽  
First Time

The study use intralesional triamcinolone acetonide injection proceduce for chalazion treatment.1. Objectives: To evaluate results of intralesional triamcinolone acetonide injection for chalazion treatment. 2. Method: This noncomparative prospective interventional trial included 72 chalazions of 61 patients. 3. Results: 61 patients (72 chalazions) with 19 males (31.1%) và 42 females (68.9%), the mean age was 24 ± 9,78 years. 31.1% patients was the first time chalazion and 68.9% patients was more than one times chalazion including 78.6% patients was recurrent at the first position and 21.4% patients occur at new position. 72 chalazions with 16 (22.2%) chalazions was treated before and 56 (77.8%) chalazions wasn’t done that. 72 chalazions with 49 chalazions (68.1%) are local in upper eyelid and 23 chalazions (31.9%) are local in lower eyelid. The mean of chalazion diameter is 6.99 ± 3.03mm. Intralesional triamcinolone acetonide is injected to treat 72 chalazions with 16 (22.2%) chalazions are injected through the route of skin and 56 (77.8%) chalazions are injected through the route of conjunctiva. After 2 weeks follow-up, the success rate was 93.1% and 6.9% failed. 4. Conclusion: intralesional triamcinolone acetonide injection for chalazion treatment is really effective. Key words: chalazion, intralesional triamcinolone acetonide.

Understanding the Obstacles to Uptake of Intervention Programmes and Services for Persons with Dementia

2020 ◽  
Vol 17 (6) ◽  
pp. 526-533
Author(s):  
Ha N.H. Lien ◽  
Emily J. Koh ◽  
Philip L.K. Yap
Keyword(s):  
Medical Records ◽  
Cognitive Engagement ◽  
Functional Improvement ◽  
Related Factors ◽  
Related Services ◽  
Phone Calls ◽  
Information Session ◽  
Adequate Information ◽  
Care At Home

Background: Utilisation of intervention programmes and services for Persons with Dementia (PWD) has been generally modest despite the growing numbers. One reason has been the lack of knowledge about dementia and information on such services. Objective: We sought to close this gap by providing caregivers with an information session about dementia and the importance and availability of related services. We explored the uptake of intervention programmes and services and reasons for non-uptake thereafter. Methods: Two hundred and seventy-five PWD and caregiver dyads attended the Dyad Education and Empowerment Programme (DEEP). At the DEEP, while caregivers underwent an information session, PWD were assessed by a multidisciplinary team on their need and suitability for programmes and services such as daycare, cognitive engagement programmes and physical rehabilitation. The dyads then received individualized recommendations on the appropriate services, if any. Follow-up through medical records review and phone calls was conducted one month after DEEP to ascertain if the dyads had acted upon the recommendations and if not, what difficulties they encountered. Results: One hundred and eleven PWD received recommendations, of which 40 (36.0%) agreed and enrolled in the services while 71 (64%) declined. Thematic analysis of the reasons for non-uptake revealed 3 themes: PWD-related factors (e.g., refusal, functional improvement or decline), caregiverrelated factors (adequacy of care at home, other care arrangements), and service-related factors (e.g., cost, timing). Conclusion: Despite adequate information, there are other reasons for non-uptake of dementia- related services, some of which should be addressed to improve service updates and to provide better care for PWD.

A Novel Surgical Technique for Large Frontoencephalocele Management: The Mercy Ships Approach

FACE ◽  
2021 ◽  
pp. 273250162097932
Author(s):  
Naikhoba C. O. Munabi ◽  
Eric S. Nagengast ◽  
Gary Parker ◽  
Shaillendra A. Magdum ◽  
Mirjam Hamer ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Intraoperative Complications ◽  
Complication Rates ◽  
The Novel ◽  
Middle Income ◽  
Middle Income Countries ◽  
Lumbar Drain ◽  
Cerebral Herniation ◽  
Long Nose

Background: Large frontoencephaloceles, more common in low and middle-income countries, require complex reconstruction of cerebral herniation, elongated nose, telecanthus, and cephalic frontal bone rotation. Previously described techniques involve multiple osteotomies, often fail to address cephalad brow rotation, and have high complication rates including up to 35% mortality. This study presents a novel, modified, single-staged technique for frontoencephalocele reconstruction performed by Mercy Ships. This technique, which addresses functional and aesthetic concerns with minimal osteotomies, may help improve outcomes in low resources settings. Methods: Retrospective review was performed of patients who underwent frontoencephalocele reconstruction through Mercy Ships using the technique described. Patient data including country, age, gender, associated diagnoses, and prior interventions were reviewed. Intraoperative and post-operative complications were recorded. Results: Eight patients with frontoencephalocele (ages 4-14 years) underwent surgery with the novel technique in 4 countries. Average surgical time was 6.0 ± 0.9 hours. No intraoperative complications occurred. Post-operatively 1 patient experienced lumbar drain dislodgement requiring replacement and a second had early post-operative fall requiring reoperation for hardware replacement. In person follow-up to 2.4 months showed no additional complications. Follow-up via phone at 1 to 2 years post-op revealed all patients who be satisfied with surgical outcomes. Conclusions: Reconstruction of large frontoencephaloceles can be challenging due to the need for functional closure of the defect and craniofacial reconstruction to correct medial hypertelorism, long nose deformity, and cephalad forehead rotation. The novel surgical technique presented in this paper allows for reliable reconstruction of functional and aesthetic needs with simplified incision design, osteotomies, and bandeau manipulation.

scholarly journals Endoscopically controlled surgery with open hemilaminectomy for the treatment of intradural extramedullary tumors: an operative technique and short-term outcomes of 20 consecutive cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically controlled surgery with open hemilaminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically controlled surgery with open hemilaminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short-term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically controlled surgery with open hemilaminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

scholarly journals Endoscopic treatment of suprasellar cysts without hydrocephalus

2016 ◽  
Vol 18 (4) ◽  
pp. 434-441 ◽  
Author(s):  
Song-Bai Gui ◽  
Sheng-Yuan Yu ◽  
Lei Cao ◽  
Ji-wei Bai ◽  
Xin-Sheng Wang ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Success Rate ◽  
Patient Outcomes ◽  
Endoscopic Treatment ◽  
Foramen Of Monro ◽  
Image Guided ◽  
Operative Complications ◽  
Appropriate Therapy ◽  
Endoscopic Fenestration

OBJECTIVE At present, endoscopic treatment is advised as the first procedure in cases of suprasellar arachnoid cysts (SSCs) with hydrocephalus. However, the appropriate therapy for SSCs without hydrocephalus has not been fully determined yet because such cases are very rare and because it is usually difficult to perform the neuroendoscopic procedure in patients without ventriculomegaly given difficulties with ventricular cannulation and the narrow foramen of Monro. The purpose of this study was to find out the value of navigation-guided neuroendoscopic ventriculocystocisternostomy (VCC) for SSCs without lateral ventriculomegaly. METHODS Five consecutive patients with SSC without hydrocephalus were surgically treated using endoscopic fenestration (VCC) guided by navigation between March 2014 and November 2015. The surgical technique, success rate, and patient outcomes were assessed and compared with those from hydrocephalic patients managed in a similar fashion. RESULTS The small ventricles were successfully cannulated using navigational tracking, and the VCC was accomplished in all patients. There were no operative complications related to the endoscopic procedure. In all patients the SSC decreased in size and symptoms improved postoperatively (mean follow-up 10.4 months). CONCLUSIONS Endoscopic VCC can be performed as an effective, safe, and simple treatment option by using intraoperative image-based neuronavigation in SSC patients without hydrocephalus. The image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of hydrocephalus in patients with SSC may not be a contraindication to endoscopic treatment.

scholarly journals Hi-PoAD technique for Adolescent Idiopathic Scoliosis in Adult: Personal case series

2021 ◽  
Author(s):  
Cesare Faldini ◽  
Francesca Barile ◽  
Fabrizio Perna ◽  
Stefano Pasini ◽  
Michele Fiore ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Idiopathic Scoliosis ◽  
Case Series ◽  
Deformity Correction ◽  
Pedicle Screws ◽  
Mechanical Complication ◽  
Non Union ◽  
Implant Retention ◽  
Surgical Data

Abstract Purpose The aim of this article is to present an original surgical technique for the treatment of rigid Adult Idiopathic Scoliosis (AdIS) and the results at minimum 2 years follow-up in a cohort of 40 patients. Methods We retrospectively reviewed 40 patients affected by rigid AdIS, older than 40 years and operated with a posterior one stage surgical technique summarized with the acronym Hi-PoAD, (high-density pedicle screws, Ponte osteotomies, asymmetric rods contouring, direct vertebral rotation). The demographic and surgical data were collected, and the improvement of clinical scores and radiologic parameters was obtained after surgery, at 1 and 2 years and at final follow-up, to assess deformity correction, coronal and sagittal balance and clinical outcome. Results The average follow-up was 2.9 years (range 2–3.5). Average coronal Cobb angle decreased from 65.0° ± 8.4 to 18.9° ± 3.9 (p < 0.01). Rotation sagittal angle decreased from 26.2° ± 4.4° to 12.4° ± 2.8° (p < 0.01). Mean thoracic kyphosis improved from 23.1° ± 3.6° to 36.0° ± 3.9°. SRS-22 improved form 2.9 ± 0.4 to 3.7 ± 0.6 (p < 0.01). Four early post-operative deep wound infections were observed, all healed after debridement and implant retention. No mechanical complication, junctional kyphosis, deformity progression or non-union were recorded at the last follow-up. Conclusions Hi-PoAD technique proved to be safe and effective in the treatment of rigid Adult Idiopathic Scoliosis. The reason for the success is related to the combined strategies adopted, that dissipates corrective forces over several levels, reducing mechanical stress at the screw–bone interface and optimizing corrective potential.

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