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Biomedical subjects

B S Sires

Publications and source records attributed to B S Sires.

29 records · Page 2Linked to original sources

Eyelid splitting with excision or microhyfrecation for distichiasis.

Distichiasis is a rare congenital or acquired condition in which an accessory row of eyelashes arises from the posterior lamella of the eyelid margin. Previously described surgical techniques to treat distichiasis can result in complications including trichiasis, loss of normal eyelashes, cicatricial entropion, and eyelid margin deformities. We describe a new technique in which the eyelid margin is split to expose the distichiasis eyelash follicles. Each aberrant eyelash follicle is individually excised or microhyfrecated and then removed. Seventeen eyelids in 5 patients with congenital or acquired distichiasis have been treated. We have achieved excellent functional and cosmetic results using this new technique.

Adolescent↗

Osteogenin-enhanced bone-specific differentiation in hydroxyapatite orbital implants.

Hydroxyapatite orbital implants undergo early ingrowth of fibrovascular tissue after enucleation. This animal study determined whether control and osteogenin-impregnated hydroxyapatite orbital implants vary in their osteogenic response at 6 and 52 weeks. Rabbits underwent enucleation with implantation of control or osteogenin-impregnated hydroxyapatite spheres. Light microscopy determined fibrovascular ingrowth, and histomorphometry quantitated the amount of bone produced. Osteogenin implants vascularized at a faster rate and contained bony foci by 6 weeks that became confluent at 1 year. Spontaneous osteogenesis was not seen in control animals at 6 weeks. After 1 year they contained bone, although less than in the osteogenin implants. Mixed cell inflammation was observed at the hydroxyapatite-tissue interface in both groups. No inflammation was noted at the interface of hydroxyapatite and bone. These are the first controlled observations that bone-specific differentiation occurs in the pores of spherical hydroxyapatite implants within the soft tissues of the socket. This vascularized process can be enhanced with osteogenin to occur earlier and more uniformly in the implants at one year.

Animals↗

Histological and radiological analyses of hydroxyapatite orbital implants in rabbits.

To date, only anectodal clinical data exist pertaining to the histological changes of hydroxyapatite within an enucleated socket. This study was conducted to determine the histological and radiological changes in a coralline hydroxyapatite sphere placed into the central socket, in a controlled fashion. Rabbits underwent simple enucleation with implantation of an autologous sclera-wrapped hydroxyapatite spheres with extraocular muscle reattachment. Preoperatively, the mineral density of each sphere was determined using quantitative computed tomography (CT) that was repeated 2- and 6 weeks postoperatively. The implants were harvested at 2- and 6 weeks and submitted for light and electron microscopic analysis. The results demonstrated a uniform influx of fibrovascular tissue that did not reach the center of the implant, even at 6 weeks. A marked mixed-cell inflammatory response was noted at the interface between the fibrovascular tissue and the hydroxyapatite. Giant cells were noted only at the scleral windows. This study demonstrated that the early response to hydroxyapatite implants was fibrovascular ingrowth with mixed-cell inflammation. These histological observations correlated with findings observed with quantitative CT. Quantitative CT appears to be an ideal modality for observing the early temporal tissue density changes in hydroxyapatite implants.

Animals↗

Use of demineralized bone as an osteoinductive orbital enucleation implant in the rabbit.

Implanted allogeneic demineralized bone particles (DBP) may be transformed into endochondral bone by inductive or conductive new bone formation. Using a rabbit model, enucleation or evisceration was performed, and DBP was implanted into the socket. Histology confirmed endochondral bone formation in both groups. A morphologic difference existed between enucleation and evisceration: compact bone was produced following evisceration, and cancellous bony spheres were formed following enucleation. Serial quantitative computed tomography (qCT) was performed to monitor mineral density and proved to be an ideal technique to monitor bone mineralization noninvasively in the postoperative orbit. Bone mineral density (BMD, mg/ml) increased approximately 300% in DBP implanted orbits when compared to controls at 6 weeks. The ideal mass/volume ratio of DBP to socket volume was 400 mg/ml. The rapidly formed bone is well vascularized and creates a stable integrated orbital implant, following enucleation and evisceration surgery. DBP implantation into the central orbit results in inductive bone formation with interesting potential in socket and orbit reconstruction.

Animals↗

Variability of mineral density in coralline hydroxyapatite spheres: study by quantitative computed tomography.

Quantitative computed tomography (qCT) can be employed to determine the mineral density (MD) of bone or similar mineralized alloplastic materials with high precision. Porous spheres made from coralline hydroxyapatite are currently used for reconstruction after enucleation procedures. The long-term fate of these implants is unknown. Using qCT, MD was determined in hydroxyapatite spheres prior to implantation. Intersphere MD varied up to 200% with a near Gaussian distribution. Intrasphere MD did not vary significantly when comparing central to peripheral sites. The density of coralline hydroxyapatite spheres was approximately 400% greater than the density of newly formed endochondral bone. This study demonstrates that qCT data were an invaluable tool for MD determination, detecting a marked variability in hydroxyapatite MDs. Because the long-term fate of these implants is unknown and fibrovascular ingrowth is an important event in the integration of these implants, monitoring of MDs of coralline hydroxyapatite implants is of interest.

Densitometry↗