Autologous pericranium grafts for large orbital implants

2020 ◽  
pp. 112067212094059
Author(s):  
Nuria Ibáñez Flores ◽  
Roberto Secondi ◽  
Erika Becerra Rangel
Keyword(s):  
Orbital Implant ◽  
Orbital Volume ◽  
Group A ◽  
Contracted Socket ◽  
Patient Series ◽  
Volume Deficit ◽  
The Aesthetic ◽  
Study Participants ◽  
Anophthalmic Socket

Introduction: Insufficient orbital volume in an anophthalmic socket is a major problem for the placement of an ocular prosthesis. This study reports the outcomes of the use of autologous pericranium graft in association with a large primary or secondary orbital implant in patients with a contracted socket and large orbital volume deficit. Methods: This was a retrospective single-institution study. Participants were 13 patients with contracted socket, volume deficit, and insufficient conjunctiva to cover the new implant divided into two groups, A ( n = 3) and B ( n = 10), according to the baseline condition of the socket. Surgery was primary evisceration (group A only) and placement of a large orbital implant followed by an autologous pericranium graft over the implant (groups A and B). Results: Mean follow-up duration for the patient series was 9.5 months (range 9–24). Complete epithelialization of the pericranium graft was recorded at 47.3 days of follow-up (range 33–67). No cases of implant exposure or shrinkage were noted during follow-up. Main postoperative complications were conjunctival granuloma (five patients, 38.5%), conjunctival seroma (one patient, 7.7%). All patients were satisfied with the aesthetic outcome. Conclusion: Autologous pericranial graft was effective in reconstructing the contracted socket so that the anophthalmic socket could accommodate a larger or secondary orbital implant. The efficacy of this procedure needs to be confirmed in a larger patient series.

Complications of the Anophthalmic Socket

2011 ◽  
Author(s):  
John D. McCann ◽  
Chun Cheng Lin Yang
Keyword(s):  
Soft Tissue ◽  
Ocular Surface ◽  
Orbital Fractures ◽  
Orbital Trauma ◽  
Orbital Implant ◽  
Soft Tissue Volume ◽  
Eyelid Malposition ◽  
Volume Deficit ◽  
Anophthalmic Socket ◽  
Orbital Soft Tissue

The anophthalmic socket is subject to four major deformities: enophthalmos, exposure, eyelid malposition, and socket contraction. Enophthalmos occurs when there is a lack of soft tissue volume, creating a sunken or hollow appearance. Exposure occurs when a previously placed orbital implant erodes through the ocular surface. Eyelid malposition occurs largely as a consequence of wearing of a prosthesis. Socket contraction occurs when there is insufficient ocular surface area and fornix depth to accommodate a mobile prosthesis. Understanding these disfigurements and their treatments is the goal of this chapter. Anopththalmic enophthalmos is an acquired condition that occurs when there is a lack of orbit volume after removal of the eye. In a typical case 6 mL of volume is lost with removal of the eye. An orbital implant will replace 2 to 4 mL of volume, and a prosthesis will replace 1 to 2 mL of volume. This leaves a volume deficit of 1 to 3 mL. This typical volume deficit can be exacerbated by fat and muscle atrophy secondary to surgery or antecedent trauma. In cases of eyes removed secondary to orbital trauma, unrepaired orbital fractures expand the bony orbit, further exacerbating the lack of orbital soft tissue. After removal of the eye the orbital implant and the inadequate volume of orbital soft tissue tend to settle toward the orbital floor, creating more of a volume deficit in the superior orbit. The orbital fat is somewhat liquid and much of the preaponeurotic fat in the upper eyelid flows posterior and inferior, creating the hollow appearance in the superior fornix of the anophthalmic socket. This deformity is referred to as the superior sulcus deformity and is present in some degree in the majority of anophthalmic sockets. 24-1-1 Diagnosis. History-taking should direct the ophthalmologist toward the cause of the patient’s anophthalmos. If the eye was lost to trauma, the possibility of orbital fractures expanding the orbital volume and exacerbating the condition should be considered. If the socket was radiated, the possibility of radiation-induced orbital soft tissue atrophy should be considered.

scholarly journals Shallow Inferior Conjunctival Fornix in Contracted Socket and Anophthalmic Socket Syndrome: A Novel Technique to Deepen the Fornix Using Fascia Lata Strips

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mohamed F. K. Ibrahiem ◽  
Sahar T. A. Abdelaziz
Keyword(s):  
Lower Eyelid ◽  
Fascia Lata ◽  
Controlled Study ◽  
Control Group ◽  
Contracted Socket ◽  
Eyelid Malposition ◽  
Skin Scar ◽  
Inferior Fornix ◽  
Anophthalmic Socket

Purpose.To evaluate a new surgical technique using fascia lata to deepen the shallow inferior conjunctival fornix in contracted socket and anophthalmic socket syndrome.Methods.A prospective controlled study in which 24 sockets of 24 patients who were unable to wear and retain their ocular prosthesis due to shallow inferior fornix were enrolled and categorized into anophthalmic socket syndromes (9 patients) and contracted sockets (15 patients). Another 24 patients who underwent evisceration or enucleation with healthy sockets and can wear and retain their prosthesis comfortably were chosen as a control group. Deepening of the fornix was performed using fascia lata strips under general anesthesia. Central depth of the inferior fornix was measured preoperatively and postoperatively.Results.A statistically significant improvement of the postoperative central inferior fornix depth was reported which was marked in anophthalmic subgroup. 100% of anophthalmic sockets and 93.3% of contracted sockets achieved satisfactory results during the follow-up period with no postoperative lower eyelid malposition or obvious skin scar.Conclusion.Fascia lata technique is a new alternative and effective procedure to deepen the shallow inferior fornix that can be used in moderate to severe contracted sockets or anophthalmic socket syndrome with minimal lower eyelid or socket complications.

scholarly journals Spontaneous clearance of Chlamydia trachomatis accounting for bacterial viability in vaginally or rectally infected women (FemCure)

2020 ◽  
Vol 96 (7) ◽  
pp. 541-548 ◽  
Author(s):  
Nicole H T M Dukers-Muijrers ◽  
Kevin J H Janssen ◽  
Christian J P A Hoebe ◽  
Hannelore M Götz ◽  
Maarten F Schim van der Loeff ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Quantitative Pcr ◽  
Spontaneous Clearance ◽  
Registration Number ◽  
Group A ◽  
Untreated Female ◽  
Group B ◽  
Study Participants ◽  
Ct Dna

ObjectivesSpontaneous clearance of Chlamydia trachomatis (CT) infections can occur between diagnosis and treatment. We followed CT patients to assess clearance using a conventional definition (no total CT-DNA, assessed by routine quantitative PCR methods) and a definition accounting for viability, assessed by viability PCR testing.MethodsThree outpatient STI clinics included CT-diagnosed women (The Netherlands, 2016–2017, FemCure study); participants had vaginal CT (vCT) and rectal CT (rCT) (group A: n=155), vCT and were rectally untested (group B: n=351), single vCT (group C: n=25) or single rCT (group D: n=29). Follow-up (median interval 9 days) vaginal and rectal samples underwent quantitative PCR testing (detecting total CT-DNA). When PCR positive, samples underwent V-PCR testing to detect ‘viable CT’ (CT-DNA from intact CT organisms; V-PCR positive). ‘Clearance’ was the proportion PCR-negative patients and ‘clearance of viable CT’ was the proportion of patients testing PCR negative or PCR positive but V-PCR negative. We used multivariable logistic regression analyses to assess diagnosis group (A–D), age, days since initial CT test (diagnosis) and study site (STI clinic) in relation to clearance and clearance of viable CT.ResultsClearance and clearance of viable CT at both anatomic sites were for (A) 0.6% and 3.9%; (B) 5.4% and 9.4%; (C) 32.0% and 52.0% and (D) 27.6% and 41.4%, respectively. In multivariate analyses, women with single infections (groups C and D) had higher likelihood of clearance than women concurrently infected with vCT and rCT (p<0.001).Of rectally untested women (group B), 76.9% had total CT-DNA and 46.7% had viable CT (V-PCR positive) at the rectal site.ConclusionsOf untreated female vCT patients who had CT also at the rectal site, or who were rectally untested, only a small proportion cleared CT (in fact many had viable CT) at their follow-up visit (median 9 days). Among single site infected women clearance was much higher.Trial registration numberNCT02694497.

Absorbable suture material in carotid surgery

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Vincenzo Gasbarro ◽  
Luca Traina ◽  
Francesco Mascoli ◽  
Vincenzo Coscia ◽  
Gianluca Buffone ◽  
...  
Keyword(s):  
Suture Material ◽  
Absorbable Suture ◽  
Paediatric Surgery ◽  
Carotid Surgery ◽  
Suture Materials ◽  
Absorbable Suture Material ◽  
Absorbable Sutures ◽  
Group A ◽  
Group B

Abstract. Background: Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery. Patients and methods: In an 11 year period, 1126 patients (659 male [58.5 %], 467 female [41.5 %], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered. Results: A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5 % and 2.0 % for group A, respectively, and 11.8 % and 12.9 % for group B, respectively. Conclusions: In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.

Seven-Year Follow-Up of Screening for Hypertension and Diabetes at a Dental Clinic

2019 ◽  
Author(s):  
Göran Friman
Keyword(s):  
Antihypertensive Drugs ◽  
Study Data ◽  
Initial Screening ◽  
Pharmacological Treatments ◽  
Medical Screening ◽  
Follow Up Study ◽  
Undiagnosed Hypertension ◽  
Dental Setting ◽  
Study Participants

Objective: To describe the distribution of risk, diagnosis and pharmacological treatments for diabetes and hypertension after seven years among patients provided with opportunistic medical screening in a dental setting. Material and Methods: The initial screening’s 170 participants were asked to take part in a seven-year follow-up study. Data were collected through self-reported information in a written health declaration. Outcome measures: • Number of study participants who had passed away • Prescription of antidiabetics or antihypertensives • Changes in weight and height to calculate body mass index (BMI) Results: The follow-up study consisted of 151 participants. Twenty had passed away. The risk needs for medicating with antihypertensive drugs after seven years for those not receiving pharmacological treatment at the initial screening was 3.7 times greater (p=0.025 CI 1.2-11.3) for participants with a diastolic blood pressure (BP) ≥ 90 mm Hg (85 for diabetics) than for the others. The risk was 3.9 times greater (p=0.020 CI 1.2-12.6) for those with a systolic BP of 140-159 mm Hg and 54.2 times greater (p<0.0001 CI 9.8-300.3) for those with a systolic BP ≥ 160 mm Hg than for those with a systolic BP 140 mm Hg. There were no changes in BMI. Conclusion: At least one in ten cases of incorrect medication or undiagnosed hypertension may be identifiable through opportunistic medical screening

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

A Study on Frozen Shoulder and its clinical management through Nasaapana and Nasya

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth
Keyword(s):  
Medical Science ◽  
Frozen Shoulder ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Animal Kingdom ◽  
Shoulder Joints ◽  
Group A ◽  
Group B

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

A Comparative Study of Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana in the Management of Shweta Pradara

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Renuka M. Tenahalli
Keyword(s):  
Vitamin C ◽  
Early Stage ◽  
Pathological Condition ◽  
Before And After ◽  
Group A ◽  
Phosphorus Iron ◽  
Group B ◽  
Busy Schedule ◽  
Iron And Calcium

Shweta Pradara (Leucorrhoea) is the disease which is characterized by vaginal white discharge. Vaginal white discharge this symptom is present in both physiological and pathological condition, when it becomes pathological it disturbs routine life style of the woman. Most of the women in the early stage will not express the symptoms because of hesitation and their busy schedule. If it is not treated it may leads to chronic diseases like PID (Garbhashaya Shotha etc.) Charaka mentioned Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana. This treatment is used in Shweta Pradara shown positive results, hence a study was under taken to assess its clinical efficacy. 30 diagnosed patients of Shweta Pradara were randomly selected, allocated in three groups. Group A and Group B received Amalaki Choorna with Madhu and Vata Twak Kashaya Yoni Pichu Dharana respectively and Group C received Amalaki Choorna with Madhu followed by Vata Twak Kashaya Yoni Pichu Dharana for 15 days. The patients were assessed for the severity of the symptoms subjectively and objectively before and after the treatment and at the end of the follow up. Data from each group were statistically analyzed and were compared. No side effects were noted and it may be considered as an effective alternative medicine in Shweta Pradara (leucorrhea). Amalaki is rich in natural source of vitamin C and contains phosphorus, iron and calcium. Honey contains carbohydrate, vitamin C, phosphorus iron and calcium. All together these help to increase Hb% and immunity. Vata Twak Kashaya contains tannin which helps to maintain normal pH of the vagina.

TRATAMENTO CIRÚRGICO DE CANINO INCLUSO EM REGIÃO MENTUAL: RELATO DE CASO

2019 ◽  
Author(s):  
Rodrigo Figueiredo de Brito Resende
Keyword(s):  
Surgical Treatment ◽  
Key Words ◽  
Oral Surgery ◽  
Tooth Eruption ◽  
Points Of View ◽  
The Aesthetic ◽  
Relationship Of ◽  
Transverse Position

RESUMOO dente denominado incluso nada mais é que um dente retido ou impactado dentro do alvéolo dentário de maneira parcial ou completa que não conseguiu erupcionar por motivos patológicos ou simplesmente anatômicos após o período de rizogênese. O canino, em especial, é de suma importância sob os pontos de vista estético e funcional. O deslocamento do canino incluso ultrapassando, ou se aproximando da linha média antes da erupção dentária do mesmo, é mais frequente na mandíbula do que na maxila.  Este trabalho tem por objetivo descrever o caso de um paciente de 21 anos que apresentava um canino incluso na região mentual, em posição transversal, inicialmente visualizado em uma radiografia periapical e posteriormente submetido a radiografia com a técnica de Donavan. Através de uma radiografia oclusal, foi possível observar o posicionamento do dente para a vestibular mentoniana e íntima relação do dente retido com as raízes dos incisivos centrais decíduos do paciente. Foi realizada a extração do dente retido no mento, removendo o mesmo por completo sendo feitas osteotomias e odontossecções. O paciente está em acompanhamento clínico à 1 ano após o tratamento cirúrgico.Palavras – chave: Dente incluso; Cirurgia Oral; Imaginologia. ABSTRACTThe tooth inserted  is nothing more than a tooth retained or impacted within the dental socket partially or completely that failed to erupt for pathological or simply anatomical reasons after the period of rhizogenesis. The canine, in particular, is of the utmost importance from the aesthetic and functional points of view. The displacement of the canine, even surpassing or approaching the midline before tooth eruption, is more frequent in the mandible than in the maxilla. This work aims to describe the case of a 21 - year - old patient who had a canine included in the mental region, in a transverse position, which was initially visualized on a periapical radiograph and later submitted to radiography with the Donavan technique. An occlusal radiograph showed the positioning of the tooth for the mental vestibular and the intima relationship of the retained tooth with the roots of the patient's central deciduous incisors. Removal of the tooth retained in the denture was performed, removing the tooth completely and osteotomies and odontosections were performed. The patient is in clinical follow-up at 1 year after the surgical treatment. key words: Tooth included; Oral surgery; Imaginology.  

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