scholarly journals Management of stretched scar– induced secondary strabismus

2020 ◽  
Author(s):  
Mohamed F Farid ◽  
Mohamed A Awwad ◽  
Mohamed R Mahmoud
Keyword(s):  
Retrospective Review ◽  
Scar Tissue ◽  
Surgical Correction ◽  
Characteristic Appearance ◽  
Absorbable Sutures ◽  
Recurrent Exotropia ◽  
Consecutive Esotropia ◽  
Made In

Abstract BACKGROUND: To determine characteristics and management of consecutive or recurrent strabismus secondary to stretched scar. METHODS: This is a retrospective review of all patients diagnosed with late secondary consecutive or recurrent strabismus due to stretched scar from 2012 to 2017. The diagnosis of stretched scar was made in any case of late (≥ 1 month) consecutive or recurrent strabismus associated with underaction of the previously operated muscle. The diagnosis was confirmed intraoperatively by negative forced duction test and the characteristic appearance of the scar tissue. Surgical correction involved excision of the scar tissue with muscle re-attachment to the sclera using non-absorbable sutures. Study parameters include improvement in secondary deviations, degree of muscle underaction and diplopia. RESULTS: 21 consecutive and 6 recurrent cases of stretched scar –induced strabismus were identified and all cases were associated with variable degrees of limited ocular duction. After surgical correction of the stretched scar, consecutive deviations in the form of consecutive esotropia and exotropia were corrected by means of 26.1PD and 65.6PD while recurrent deviations in the form recurrent exotropia and recurrent hypertropia were corrected by means of 34.3PD and 11PD respectively with significant improvement of limited ocular ductions. 21 patients had diplopia at presentation and all were improved after surgery. CONCLUSION: management of stretched scar –induced secondary strabismus by excision of the stretched scar and muscle fixation to the sclera using non-absorbable sutures significantly corrects secondary deviations and improves limitation of ocular duction.

scholarly journals Management of stretched scar– induced secondary strabismus

2019 ◽  
Author(s):  
Mohamed F Farid ◽  
Mohamed A Awwad ◽  
Mohamed R Mahmoud
Keyword(s):  
Retrospective Review ◽  
Scar Tissue ◽  
Surgical Correction ◽  
Characteristic Appearance ◽  
Absorbable Sutures ◽  
Recurrent Exotropia ◽  
Consecutive Esotropia ◽  
Made In

Abstract BACKGROUND: To determine characteristics and management of consecutive or recurrent strabismus secondary to stretched scar. METHODS: This is a retrospective review of all patients diagnosed with late secondary consecutive or recurrent strabismus due to stretched scar from 2012 to 2017. The diagnosis of stretched scar was made in any case of late (≥ 1 month) consecutive or recurrent strabismus associated with underaction of the previously operated muscle. The diagnosis was confirmed intraoperatively by negative forced duction test and the characteristic appearance of the scar tissue. Surgical correction involved excision of the scar tissue with muscle re-attachment to the sclera using non-absorbable sutures. Study parameters include improvement in secondary deviations, degree of muscle underaction and diplopia. RESULTS: 21 consecutive and 6 recurrent cases of stretched scar –induced strabismus were identified and all cases were associated with variable degrees of limited ocular duction. After surgical correction of the stretched scar, consecutive deviations in the form of consecutive esotropia and exotropia were corrected by means of 26.1PD and 65.6PD while recurrent deviations in the form recurrent exotropia and recurrent hypertropia were corrected by means of 34.3PD and 11PD respectively with significant improvement of limited ocular ductions. 21 patients had diplopia at presentation and all were improved after surgery. CONCLUSION: management of stretched scar –induced secondary strabismus by excision of the stretched scar and muscle fixation to the sclera using non-absorbable sutures significantly corrects secondary deviations and improves limitation of ocular duction.

scholarly journals Management of stretched scar– induced secondary strabismus

2019 ◽  
Author(s):  
Mohamed F Farid ◽  
Mohamed A Awwad ◽  
Mohamed R Mahmoud
Keyword(s):  
Retrospective Review ◽  
Scar Tissue ◽  
Surgical Correction ◽  
Characteristic Appearance ◽  
Absorbable Sutures ◽  
Recurrent Exotropia ◽  
Consecutive Esotropia ◽  
Made In

Abstract BACKGROUND: To determine characteristics and management of consecutive or recurrent strabismus secondary to stretched scar. METHODS: This is a retrospective review of all patients diagnosed with late secondary consecutive or recurrent strabismus due to stretched scar from 2012 to 2017. The diagnosis of stretched scar was made in any case of late (≥ 1 month) consecutive or recurrent strabismus associated with underaction of the previously operated muscle. The diagnosis was confirmed intraoperatively by negative forced duction test and the characteristic appearance of the scar tissue. Surgical correction involved excision of the scar tissue with muscle re-attachment to the sclera using non-absorbable sutures. Study parameters include improvement in secondary deviations, degree of muscle underaction and diplopia. RESULTS: 21 consecutive and 6 recurrent cases of stretched scar –induced strabismus were identified and all cases were associated with variable degrees of limited ocular duction. After surgical correction of the stretched scar, consecutive deviations in the form of consecutive esotropia and exotropia were corrected by means of 26.1PD and 65.6PD while recurrent deviations in the form recurrent exotropia and recurrent hypertropia were corrected by means of 34.3PD and 11PD respectively with significant improvement of limited ocular ductions. 21 patients had diplopia at presentation and all were improved after surgery. CONCLUSION: management of stretched scar –induced secondary strabismus by excision of the stretched scar and muscle fixation to the sclera using non-absorbable sutures significantly corrects secondary deviations and improves limitation of ocular duction.

scholarly journals Management of stretched scar– induced secondary strabismus

2020 ◽  
Author(s):  
Mohamed F Farid ◽  
Mohamed R Mahmoud ◽  
Mohamed A Awwad
Keyword(s):  
Retrospective Review ◽  
Scar Tissue ◽  
Surgical Correction ◽  
Characteristic Appearance ◽  
Absorbable Sutures ◽  
Recurrent Exotropia ◽  
Consecutive Esotropia ◽  
Made In

Abstract BACKGROUND: To determine characteristics and management of consecutive or recurrent strabismus secondary to stretched scar. METHODS: This is a retrospective review of all patients diagnosed with late secondary consecutive or recurrent strabismus due to stretched scar from 2012 to 2017. The diagnosis of stretched scar was made in any case of late (≥ 1 month) consecutive or recurrent strabismus associated with underaction of the previously operated muscle. The diagnosis was confirmed intraoperatively by negative forced duction test and the characteristic appearance of the scar tissue. Surgical correction involved excision of the scar tissue with muscle re-attachment to the sclera using non-absorbable sutures. Study parameters include improvement in secondary deviations, degree of muscle underaction and diplopia. RESULTS: 21 consecutive and 6 recurrent cases of stretched scar –induced strabismus were identified and all cases were associated with variable degrees of limited ocular duction. After surgical correction of the stretched scar, consecutive deviations in the form of consecutive esotropia and exotropia were corrected by means of 26.1PD and 65.6PD while recurrent deviations in the form recurrent exotropia and recurrent hypertropia were corrected by means of 34.3PD and 11PD respectively with significant improvement of limited ocular ductions. 21 patients had diplopia at presentation and all were improved after surgery. CONCLUSION: management of stretched scar –induced secondary strabismus by excision of the stretched scar and muscle fixation to the sclera using non-absorbable sutures significantly corrects secondary deviations and improves limitation of ocular duction.

Infra-popliteal deep venous thrombi and the risk of symptomatic pulmonary embolism in hospitalized patients

Vascular ◽  
2011 ◽  
Vol 19 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Saadi Alhalbouni ◽  
Anil Hingorani ◽  
Alexander Shiferson ◽  
Natalie Marks ◽  
Enrico Ascher
Keyword(s):  
Pulmonary Embolism ◽  
Lower Extremity ◽  
Retrospective Review ◽  
Lower Limb ◽  
Hospitalized Patients ◽  
Symptomatic Pulmonary Embolism ◽  
Number Of Patients ◽  
Significant Difference ◽  
Hospital Patients ◽  
Made In

Infra-popliteal veins include the tibial and peroneal veins, as well as the soleal and gastrocnemial veins collectively known as the calf muscle veins (CMVs). Acute infra-popliteal deep venous thrombi (DVTs) are often considered insignificant with regard to the risk of pulmonary embolism (PE). A retrospective review of 4035 consecutive lower extremity venous duplex scans were made in 3146 hospital patients at our Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL)-accredited vascular lab. Seven hundred sixteen (17.7%) duplex scans were positive for acute DVTs, and 112 (2.8%) were associated with PEs. The breakdown of positive duplexes for acute DVTs was as follows: 202 (28.2%) isolated femoral-popliteal DVTs with PE in 23 (11.4%), 304 (42.5%) isolated infra-popliteal DVTs with PE in 24 (7.9%) and 210 (29.3%) multilevel DVTs involving both vein segments (femoral-popliteal and infra-popliteal) with PE in 38 (18.1%). Of the 304 isolated acute infra-popliteal DVTs, 207 (68.1%) were isolated CMV DVTs with evidence of PE in 12 (5.8%). No statistically significant difference ( P = 0.27) in the risk of PE between isolated femoral-popliteal and isolated infra-popliteal DVTs was noted. A significant number of patients (5.8%) with isolated CMV DVTs developed PE. Lower limb venous scans for DVTs should evaluate the infra-popliteal veins. Hospitalized patients with infra-popliteal DVTs should receive anticoagulation.

Extravascular Masses Masquerading as Deep Venous Thrombosis

1993 ◽  
Vol 8 (4) ◽  
pp. 158-161 ◽  
Author(s):  
O. Thulesius ◽  
A. Thurin
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Duplex Ultrasound ◽  
Signs And Symptoms ◽  
Clinical Physiology ◽  
Characteristic Appearance ◽  
Non Invasive ◽  
The Right ◽  
Symptoms And Signs ◽  
Made In

Objective: To determine the incidence and characteristics of extravascular masses (EVM) giving rise to symptoms and signs of deep venous thrombosis (DVT). Design and technique: Routine ultrasound colour duplex scanning during a 6-month period. Patients: Three hundred and two inpatients and outpatients investigated on suspicion of DVT. Setting: Department of Clinical Physiology, which is the central non-invasive diagnostic unit of the county. Results: A diagnostis of DVT was made in 33%. EVM were detected in 14 patients (5%). In most cases the characteristic appearance on scanning was spindle-shaped (like a ‘mouse’) and mostly confined to the upper calf. These EVM were regarded as intramuscular haematoma or ruptured popliteal cysts. Conclusion: EVM of the leg are (1) a frequent cause of ‘pseudothrombosis' and can positively be identified by duplex ultrasound scanning: (2) most frequently found in the medial aspect of the right calf; and (3) often detected in patients with rheumatoid arthritis or patients on anticoagulant therapy and may give rise to signs and symptoms identical to DVT.

Resection and Primary Closure of Edematous Glossoepiglottic Mucosa in a Dog Causing Laryngeal Obstruction

2017 ◽  
Vol 53 (3) ◽  
pp. 180-184 ◽  
Author(s):  
Kevin J. Schabbing ◽  
Jeffrey A. Seaman
Keyword(s):  
Airway Obstruction ◽  
Surgical Resection ◽  
Soft Palate ◽  
Primary Closure ◽  
Scar Tissue ◽  
Acute Onset ◽  
Surgical Correction ◽  
Static Displacement ◽  
Complete Obstruction ◽  
English Bulldog

ABSTRACT An approximately 22 mo old male neutered English bulldog was evaluated for acute onset of dyspnea with suspected brachycephalic obstructive airway syndrome (BOAS). Laryngoscopic exam revealed diffuse, severe edema and static displacement of redundant glossoepiglottic (GE) mucosa causing complete obstruction of the larynx and epiglottic entrapment. Static displacement of the GE mucosa was observed and determined to be the overriding component of dyspnea in this patient with BOAS. Resection and primary closure with two separate, simple continuous sutures of the GE mucosa were performed. Resection and primary closure of the GE mucosa resolved the acute onset of dyspnea in this patient. Surgical correction of the stenotic nares, elongated soft palate, and everted laryngeal saccules were performed under the same anesthetic procedure. Static displacement of the GE mucosa may occur in patients with BOAS. Surgical resection and closure of the GE mucosa resolved this patient's dyspnea and is recommended in airway obstruction. It remains to be determined if primary closure and subsequent tensioning or scar tissue of the GE mucosa results in further complications related to restricted epiglottic movement.

Abbrevatio: A New Operation for Chronic Mallet Finger

1989 ◽  
Vol 14 (3) ◽  
pp. 347-349
Author(s):  
J. LIND ◽  
L. B. HANSEN
Keyword(s):  
Conservative Treatment ◽  
Scar Tissue ◽  
Surgical Correction ◽  
Mallet Finger ◽  
Suitable Alternative ◽  
Fibrous Scar Tissue

An old, but hitherto unpublished, method for surgical correction of chronic mallet finger was carried out in 42 patients. In the abbrevatio operation, the elongated tendon is transected and resutured, after which the developing fibrous scar tissue usually causes adequate shrinkage for correcting the drop-deformity. The D.I.P. joint is transfixed with a K wire in slight hyperextension for six weeks. Forty patients were studied. The result was excellent in 16 patients (40%), good in 20%, fair in 17.5% and poor in 22.5%. On average, the extension defect was decreased from 38.2% to 11.8%. The method is a suitable alternative in patients with annoying chronic mallet finger who refuse arthrodesis or further conservative treatment.

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