The Surgical Repair of Macrostomia

2009 ◽  
Vol 46 (6) ◽  
pp. 642-647 ◽  
Author(s):  
I. O. Fadeyibi ◽  
A. O. Ugburo ◽  
C. V. Ogunbanjo ◽  
C. A. Ilombu ◽  
S. A. Ademiluyi
Keyword(s):  
Surgical Technique ◽  
Surgical Complications ◽  
Operative Technique ◽  
Surgical Repair ◽  
Surgical Techniques ◽  
Facial Symmetry ◽  
Minimal Scarring

Background: Many surgical techniques have been described for the repair of macrostomia. However, most were designed for the repair of unilateral macrostomia. Most reports of repairs involved small numbers of patients. This has not allowed for evaluation of complications and comparison of various techniques. Objective: This study describes a modification of an older technique designed for unilateral macrostomia. Details of the operative technique used for the repair are described, along with the principles underlying the various steps. Materials and Methods: This study involves 13 patients operated for macrostomia using the same surgical technique. The patients were seen at a recent screening and mass surgery exercise for patients with orofacial and craniofacial deformities. Results: Eleven patients had bilateral macrostomia; two had unilateral macrostomia. No anesthetic or surgical complications occurred in any of the patients. All patients tolerated the procedure well. Oral continence and acceptable facial symmetry were restored in all patients, with minimal scarring.

Reconstruction of unicoronal plagiocephaly with a hypercorrection surgical technique

2011 ◽  
Vol 31 (2) ◽  
pp. E4 ◽  
Author(s):  
John M. Mesa ◽  
Frank Fang ◽  
Karin M. Muraszko ◽  
Steven R. Buchman
Keyword(s):  
Surgical Technique ◽  
Surgical Repair ◽  
Surgical Techniques ◽  
Senior Author ◽  
Surgical Correction ◽  
Surgical Reconstruction ◽  
Calvarial Bone ◽  
The Mean ◽  
The Aesthetic

Object Successful surgical repair of unicoronal plagiocephaly remains a challenge for craniofacial surgeons. Many of the surgical techniques directed at correcting the stigmata associated with this craniofacial deformity (for example, ipsilateral supraorbital rim elevation [vertical dystopia], ipsilateral temporal constriction, C-shaped deformity of the face, and so on) are not long lasting and often result in deficient correction and the need for secondary revision surgery. The authors posit that the cause of this relapse was intrinsic deficiencies of the current surgical techniques. The aim of this study was to determine if correction of unilateral coronal plagiocephaly with a novel hypercorrection surgical technique could prevent the relapse of the characteristics associated with unicoronal plagiocephaly. Methods The authors performed a retrospective analysis of 40 consecutive patients who underwent surgical repair of unicoronal plagiocephaly at their institution between 1999 and 2009. In all cases, the senior author (S.R.B.) used a hypercorrection technique for surgical reconstruction. Hypercorrection consisted of significant overcorrection of the affected ipsilateral frontal and anterior temporal areas in the sagittal and coronal planes. Demographic, perioperative, and follow-up data were collected for comparison. The postsurgical appearance of the forehead was documented clinically and photographically and then evaluated and scored by 2 independent graders using the expanded Whitaker scoring system. A relapse was defined as a recurrence of preoperative features that required secondary surgical correction. Results The mean age of the patients at the time of the operation was 13 months (range 8–28 months). The mean follow-up duration was 57 months (range 3 months to 9.8 years). The postsurgical hypercorrection appearance persisted on average 6–8 months but gradually dissipated and normalized. No patients exhibited a relapse of unicoronal plagiocephalic characteristics that required surgical correction. In all cases the aesthetic results were excellent. Only 3 patients required reoperation for the management of persistent calvarial bone defects (2 cases) and removal of a symptomatic granuloma (1 case). Conclusions Our study demonstrates that patients who undergo unicoronal plagiocephaly repair with a hypercorrection surgical technique avoid long-term relapse. Our results suggest that the surgical technique used in the correction of unilateral coronal synostosis is strongly associated with the prevention of postsurgical relapse and that the use of this novel method decreases the need for surgical revision.

Surgical Repair of Acute Gracilis Muscle Rupture in the Racing Greyhound

1992 ◽  
Vol 05 (01) ◽  
pp. 18-21 ◽  
Author(s):  
R. Eaton-Wells
Keyword(s):  
Retrospective Study ◽  
Surgical Technique ◽  
Surgical Repair ◽  
Gracilis Muscle ◽  
Back Muscle ◽  
Suture Materials ◽  
Muscle Rupture

A retrospective study of the surgical repair of 27 cases of acute gracilis muscle rupture ("dropped back muscle") in 23 racing greyhounds was conducted.All of the dogs suffered the injury while racing or training. Suture materials and surgical technique are described. The dogs ability to resume racing was assessed.

scholarly journals A technique for repairing rotator cuff transtendinous tears with a remnant attached to the footprint

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hyung-Suk Choi ◽  
Byung-Ill Lee ◽  
Jae-Hyung Kim ◽  
Hyung-Ki Cho ◽  
Gi-Won Seo
Keyword(s):  
Rotator Cuff ◽  
Surgical Technique ◽  
Subchondral Bone ◽  
Suture Anchor ◽  
Surgical Repair ◽  
Tendon Healing ◽  
Repair Technique

Abstract Background Some unusual rotator cuff (RC) tears are located in more proximal tendinous portions, with substantial remnant tissue attached to the footprint. The two options for surgical repair are sacrificing or preserving the remnant tissue. We introduce a surgical repair technique that preserves as much of the remnant footprint as possible. Surgical technique A double-loaded suture anchor is inserted into the subchondral bone at the medial portion of the RC footprint; the lateral remnant tissue is preserved. Each strand is shuttled and repassed through the medial portion of the tendon in a mattress fashion using a suture hook device. Then, multiple no. 1 PDS sutures are passed through the medial and lateral stumps and left untied. Strands from the suture anchor are first tied in a double mattress fashion. Then, the repair is completed by tying the remaining no. 1 PDS sutures. Conclusions We propose a remnant-preserving RC repair technique for transtendinous RC tears with sufficient tissue remaining within the RC footprint. This technique appears advantageous in terms of re-establishing an environment that promotes tendon healing after repair.

Surgical Techniques for Tonsillectomy and Perioperative Respiratory Complications in Children

2021 ◽  
pp. 019459982110151
Author(s):  
Rahul G. Baijal ◽  
Karla E. Wyatt ◽  
Teniola Shittu ◽  
Eugenia Y. Chen ◽  
Eric Z. Wei ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Chart Review ◽  
Surgical Techniques ◽  
Retrospective Chart Review ◽  
Airway Disease ◽  
Respiratory Complications ◽  
Patient Factors ◽  
Children's Hospital ◽  
Reactive Airway Disease ◽  
Children’S Hospital

Objectives The aim of this study was to determine the incidence of perioperative respiratory complications in children following tonsillectomy with cold and hot dissection surgical techniques. Study Design The study was a retrospective cohort study. Setting Retrospective chart review was performed for all children presenting for a tonsillectomy at Texas Children’s Hospital from November 2015 to December 2017. Methods Pre- and intraoperative patient factors, including surgical technique with cold or hot dissection (electrocautery or radiofrequency ablation), and perioperative anesthetic factors were collected to determine the incidence of perioperative respiratory complications. Results A total of 2437 patients underwent a tonsillectomy at Texas Children’s Hospital from November 2015 to December 2017. The incidence of perioperative respiratory complications was 20.0% (n = 487). Sickle cell disease, cardiac disease, reactive airway disease, pulmonary disease, age >2 and <3 years, and obesity, defined as a body mass index >95th percentile for age, were significant for overall perioperative respiratory complications. There was no difference in the incidence of perioperative respiratory complications in children undergoing tonsillectomy by cold or hot dissection. Conclusion Perioperative respiratory complications following tonsillectomy are more affected by patient factors than surgical technique.

scholarly journals Hospitalization time after open appendectomy by three different surgical techniques

2014 ◽  
Vol 27 (3) ◽  
pp. 188-190 ◽  
Author(s):  
Agláia Moreira Garcia XIMENES ◽  
Fernando Salvo Torres MELLO ◽  
Zailton Bezerra de LIMA-JÚNIOR ◽  
Cícero Faustino FERREIRA ◽  
Amanda Dantas Ferreira CAVALCANTI ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Open Appendectomy ◽  
Surgical Techniques ◽  
Conventional Technique ◽  
Site Infection ◽  
Hospitalization Time ◽  
Contingency Coefficient ◽  
Appendicular Stump

BACKGROUND: The choice of surgical technique to approach the appendicular stump depends mostly on skill and personal preference of the surgeon or on the protocol used in the service, and the influence of this choice in hospitalization time is not evaluated. AIM: To evaluate the relation between surgical technique and postoperative hospitalization time in patients presenting with acute appendicitis. METHODS: Retrospective analysis of 180 patients who underwent open appendectomy. These where divided into three groups according to surgical technique: conventional appendectomy (simple ligation of the stump), tobacco pouch suture and Parker-Kerr suture. Data where crossed with hospitalization time (until three days, from four to six days and over seven days). RESULTS: A hundred and eighty patients with age from 15 to 85 years where included. From these, 95 underwent conventional technique, had an average hospitalization time of 3,9 days and seven had complications (surgical site infection, seroma, suture dehiscence and evisceration). In 67 patients, tobacco pouch suture was chosen and had average hospitalization time of 3,7 days and two complications (infection and seroma). In 18 Parker-Kerr suture was made, with average hospitalization time of 2,6 days, with no complication. Contingency coefficient between the variables hospitalization time and technique was 0,255 and Cramér's V was 0,186. CONCLUSION: There was tendency to larger hospitalization time and larger number of complications in conventional appendectomy, whereas in patients where Parker-Kerr suture was performed, hospitalization time was significantly smaller.

scholarly journals Risk factors for macular pucker after rhegmatogenous retinal detachment surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toshiaki Hirakata ◽  
Yoshimune Hiratsuka ◽  
Shutaro Yamamoto ◽  
Koki Kanbayashi ◽  
Hiroaki Kobayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
Surgical Technique ◽  
Regression Models ◽  
Rhegmatogenous Retinal Detachment ◽  
Surgical Repair ◽  
Macular Pucker ◽  
Logistic Regression Models ◽  
Retinal Breaks ◽  
Increased Risk

AbstractMacular pucker, also known as an epiretinal membrane, sometimes forms after surgical repair of a rhegmatogenous retinal detachment (RRD) and can decrease visual acuity and cause aniseikonia. However, few reports are evaluating the risk factors of macular pucker using multivariate analysis. To evaluate the risk factors for macular pucker after RRD surgery, 226 patients who underwent RRD surgery and were monitored for greater than 12 months (23.2 ± 6.4 months) after surgery were analyzed retrospectively. Of these cases, macular pucker developed in 26 cases. Multiple logistic regression models of 22 clinical characteristics were performed. An increased risk of macular pucker after RRD surgery was significantly associated with preoperative vitreous haemorrhage (Odds ratio (OR), 4.71; 95% CI 1.19–18.62), multiple retinal breaks (OR, 8.07; 95% CI 2.35–27.71), re-detachment (OR, 19.66; 95% CI 4.87–79.38), and retinal detachment area (OR, 12.91; 95% CI 2.34–71.19). Macular pucker was not associated with the surgical technique. Regardless of the surgical technique used, careful observation for postoperative macular pucker is needed after RRD surgery in high-risk cases. These findings can be used to improve the surgical management of patients with RRD. (183 words).

scholarly journals EVALUATION OF A TRAINING COURSE ON OPEN VASCULAR SURGICAL TECHNIQUES IN AORTOILIAC PATHOLOGY - 5 YEARS OF EXPERIENCE

2015 ◽  
Vol 88 (2) ◽  
pp. 196-202
Author(s):  
Bogdan Stancu ◽  
Florin Beteg ◽  
Aurel Mironiuc ◽  
Aurel Muste ◽  
Claudia Gherman
Keyword(s):  
Surgical Technique ◽  
Vascular Surgery ◽  
Prospective Study ◽  
Surgical Techniques ◽  
Surgical Skills ◽  
Technical Quality ◽  
Statistical Association ◽  
Abdominal Aortic

Introduction. The aim of this prospective study was to assess the efficacy of a vascular surgery course (2008-2012), and to verify the viability and the feasibility of the vascular anastomoses.Material and method. Vascular surgical techniques performed simultaneously on pigs were: enlargement prosthetic angioplasty, abdominal aortic interposition graft and aortoiliac bypass. Endpoints of the study were the surgical skills and the technical quality, evaluated on a scale ranging from 1 (satisfactory) to 3 (very good) for our participants.Result. A significant improvement in vascular surgical skills tasks was observed during the study years and we also found a semnificative statistical association between the quality of suture and the surgical technique used (Kendall coefficient=0.71, p=0.001<0.05).Conclusions. Our course contributed to the improvement of technical vascular surgical skills of the operator teams, reproducing in vivo, in pigs, the intraoperative environment as in human patients.

scholarly journals Other Scar Types: Optimal Functional and Aesthetic Outcome of Scarring in Cleft Patients

2020 ◽  
pp. 51-57
Author(s):  
Wouter B. van der Sluis ◽  
Nirvana S. S. Kornmann ◽  
Robin A. Tan ◽  
Johan P. W. Don Griot
Keyword(s):  
Surgical Technique ◽  
Psychosocial Functioning ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Surgical Techniques ◽  
Anatomical Structures ◽  
Patient Dissatisfaction ◽  
Optimal Function ◽  
Scar Management

AbstractCleft lip and palate are facial and oral malformation due to failures in the embryologic craniofacial development during early pregnancy. A unilateral cleft lip and palate is the most common type, whereby the upper lip, the orbicularis muscle, the alveolar bone, the floor of the nose, and the hard and soft palate are interrupted, creating an open communication between nasopharynx and oropharynx. Patients with a cleft lip and palate are treated in specialized cleft centers by a multidisciplinary team. Having cleft lip and/or palate has a noteworthy impact on quality of life and psychosocial functioning. Postoperative scarring is a common cause of patient dissatisfaction. The goal of cleft lip surgery is to close the lip, provide optimal function in terms of speech, mastication, dental protection, breathing and feeding, and provide an aesthetically pleasing facial scar. Precise surgical technique and adequate aligning of anatomical structures is important for the postoperative aesthetic result and scar formation. Different surgical techniques are available for this purpose. Optimal scar management can be divided in surgical (precise surgical technique, planning, and adequate aligning of anatomical structures) and nonsurgical methods (botulinum toxin, silicone application, carbon dioxide fractional laser).

Results of Surgical Repair of Inapparent Perilymph Fistulas

1986 ◽  
Vol 95 (3_part_1) ◽  
pp. 344-346 ◽  
Author(s):  
G. Joseph Parell ◽  
Gary D. Becker
Keyword(s):  
Hearing Loss ◽  
Surgical Technique ◽  
Surgical Repair ◽  
Conductive Hearing Loss ◽  
Knowing That ◽  
Sensory Neural ◽  
Tissue Grafts ◽  
Conductive Hearing ◽  
Sensory Neural Hearing Loss

In patients who are thought to have a perilymph (PL) fistula, careful inspection of the round and oval windows during exploratory tympanotomy may be normal. The decision must then be made either to terminate the procedure—knowing that the patient's symptoms will probably continue or deteriorate—or to repair both windows as if PL fistulas were present, risking further damage to the inner ear. From a series of 14 patients explored for possible PL fistulas, we report on 6 patients with preoperative diagnoses of PL fistula, based on history, physical examination, and audiometry. Symptoms resulting from trauma were present from 10 days to 23 years before surgery. During exploratory tympanotomy, no fistulas were evident; however, both the oval and round windows were repaired with tissue grafts. Follow up—for 1 to 5 years—revealed that vertigo was relieved in all patients. Postoperatively, one patient had a mild conductive hearing loss; yet no patient sustained a sensory neural hearing loss. We conclude that patch grafting of both the oval and round windows is a safe and effective method of treating suspected, but inapparent fistulas. Patient selection, surgical technique, and results shall be detailed.

Comparison of Doty and McGoon techniques for surgical reconstruction of congenital supravalvular aortic stenosis

2021 ◽  
pp. 1-8
Author(s):  
Mehmet Biçer ◽  
Mehmet Dedemoğlu ◽  
Oktay Korun ◽  
Hüsnü F. Altın ◽  
Okan Yurdakök ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Surgical Repair ◽  
Pulmonary Stenosis ◽  
Surgical Techniques ◽  
Supravalvular Aortic Stenosis ◽  
Surgical Reconstruction ◽  
Residual Stenosis ◽  
Post Operative Period ◽  
Surgical Methods

Abstract Background: We aimed to compare the results of two surgical methods for the treatment of congenital supravalvular aortic stenosis. Methods: From May 2004 to January 2020, 29 patients underwent surgical repair for supravalvular aportic stenosis in a single centre. The perioperative evaluation of the patients was retrospectively reviewed. Results: Fifteen (51.7%) and 14 (48.2%) patients were treated with the Doty and the McGoon methods, respectively. The median age of our cohort was 4.5 (3.0–9.9) years. Ten (34.5%) patients had Williams–Beuren syndrome, and pulmonary stenosis was observed in 12 (41.3%) patients. The median follow-up time was 2.5 (0.7–7.3) years. On follow-up, five patients had residual stenosis with the McGoon technique and one with the Doty technique (p = 0.05). One patient died early in the post-operative period in the Doty group, and three patients were re-operated on due to restenosis in the McGoon group. Freedom from re-operation in the Doty group at 1, 3, 5, and 10 years was 100%. In the McGoon group, freedom from re-operation rates at the 1-, 3-, and 7-year follow-up were 100, 88.9, and 44.4%, respectively (p = 0.08). Conclusion: Our results with both surgical techniques suggest that supravalvular aortic stenosis can be treated with good results. The Doty method provided better relief for the supravalvular aortic segment, considering the residual stenosis and the re-operation rates.

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