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Biomedical subjects

D A Ellis

Publications and source records attributed to D A Ellis.

At least 37 records · Page 2Linked to original sources
PubMed1998

Anatomy of the motor innervation of the corrugator supercilii muscle: clinical significance and development of a new surgical technique for frowning.

OBJECTIVE: This study was conducted to determine the motor innervation of the corrugator supercilii muscle and, based on this information, develop a new surgical technique to treat patients with hyperfunctional corrugator muscles with deep vertical glabellar creases. METHOD: Microdissection of five fresh-frozen cadaveric heads was performed. Following this, patients presenting with a complaint of vertical glabellar creases (frown lines) due to hyperfunctional corrugator supercilii muscles were offered a new surgical technique to divide the nerve lateral to its entry into the corrugator supercilii muscle. RESULTS: The motor innervation of the corrugator supercilii muscle is constant and predictable in its course. Patients treated with motor nerve neurotomy showed considerable weakening of the corrugator supercilii muscle function as determined by clinical testing; however, the nerve lysis did not affect the glabellar depressor muscles. CONCLUSIONS: The anatomy of the motor nerve supply to the corrugator supercilii muscle is described. Lysis of the nerve appears to be safe, reliable, and effective in weakening the strength of the corrugator supercilii muscles and improving the appearance of vertical glabellar creases.

Cadaver↗
PubMed1997

The role of family influences in development and risk.

Various influences in the family environment contribute to children of alcoholics' (COAs') risk of developing alcoholism and other mental health problems. These risk factors include alcohol-specific influences, which selectively predict alcohol problems, and alcohol-nonspecific influences, which predict a variety of mental health problems. Alcohol-specific family influences include modeling of parental drinking behavior, development of alcohol expectancies, and the family's ethnic background. Parental psychopathology, the family's socioeconomic status, and general family psychopathology are examples of alcohol-nonspecific risk factors, which increase the COA's risk of behavior disorders as well as of alcoholism. The families of COA's who are at highest risk for alcoholism and other mental health problems are characterized by the aggregation of numerous alcohol-specific and alcohol-nonspecific risk factors.

Alcoholism↗
PubMed1997

Cosmetic upper-facial rejuvenation with botulinum.

OBJECTIVE: This study was conducted to evaluate the cosmetic use of botulinum toxin type A (Botox), which blocks the release of acetylcholine at the presynaptic neuromuscular junction leading to an irreversible, but temporary chemical denervation muscular paralysis and weakness. This produces a significant cosmetic improvement of wrinkling in the upper face due to hyperfunctional animation. METHOD: A prospective clinical study representing our experience with this new technique is presented. Patient selection and evaluation, classification of animation lines, techniques, results and complications are discussed. In a 15-month period, 23 patients with seven anatomic sites were injected. Twenty-three patients had the lateral aspect and the inferior aspect of their squint lines injected, and 26 patients had their glabellar frownlines injected. RESULTS: Significant improvement occurred to the average depth and length of the glabellar frownlines. The subjective improvement by the patients was also significant. Regarding the crow's feet, the lateral canthal lines showed more improvement than the inferior lateral canthal lines because the latter has a greater component of zygomaticus major and minor muscle, which contributes to the inferior lateral squint line. CONCLUSION: Botox is a safe, easy-to-use, effective modality for the temporary elimination of hyperfunctioning upper-facial muscles.

Botulinum Toxins, Type A↗
PubMed1997

The carbon dioxide laser. An alternative for the treatment of actinically damaged skin.

BACKGROUND: The treatment of complex and diffuse actinic keratoses involving the face presents a problem in that they frequently recur despite traditional treatment modalities. The carbon dioxide (CO2) laser is an effective method for resurfacing actinically damaged facial skin. OBJECTIVE: The purpose of this study is to show the usefulness of the CO2 laser for the treatment of actinically damaged skin in patients with proven actinic keratoses and squamous cell carcinoma in situ of the face. METHODS: In an office surgery setting, the Sharplan 1030 or 40C CO2 laser with the SilkTouch flashscanner attachment was utilized to treat various regions of the face in 14 patients. RESULTS: All patients were satisfied with the aesthetic outcome of their laser procedures and no clinical evidence of residual or recurrent lesions have been noted. There were no long-term complications reported. CONCLUSIONS: Based on this preliminary report, the CO2 laser appears to be an excellent alternative for the surgical treatment of premalignant lesions of the face and can be used effectively without significant complications.

Adult↗
PubMed1997

Facial rejuvenation with botulinum.

Botulinum toxin type A (Botox) blocks the release of neurotransmitter acetylcholine at the presynaptic neuromuscular junction leading to an irreversible, but temporary muscular paralysis and weakness. This can produce a significant improvement of wrinkling in the upper face caused by the actions of the facial muscles. A prospective clinical study representing a 15-month experience with this new technique is presented. Patient selection and evaluation, classification of animation lines, techniques, results, and complications are discussed.

Botulinum Toxins, Type A↗
PubMed1995

Expanded pectoralis major myocutaneous flaps in head and neck surgery.

The use of tissue expanders in head and neck surgery has been popularized since the early 1980s. Tissue expanders are currently used in nasal reconstruction, alopecia, and other head and neck defects when there is inadequate tissue or when transposition of a local flap would create a significant donor-site deformity. Occasionally, situations in head and neck reconstruction arise where local, regional, or free flaps are not available or sufficient for head and neck reconstruction. In these situations, the use of controlled tissue expansion can be employed for enlarging myocutaneous flaps for head and neck reconstructive surgery. Two cases illustrated here present the principles and techniques of this means of reconstruction.

Aged↗
PubMed1992

A simplified approach to otoplasty.

Outstanding or protruding ears are relatively common in the pediatric otolaryngology population. We propose a method of otoplasty that is simple to use and provides safe and predictable results. The technique of otoplasty is outlined in detail with emphasis on creation of a desired antehelical fold with the use of modified Mustarde sutures as well as modifications of the lobule and the need for conchal set-back.

Ear, External↗
PubMed1991

Survival of patients with acquired immune deficiency syndrome and disseminated Mycobacterium avium complex infection with and without antimycobacterial chemotherapy.

The contribution of disseminated Mycobacterium avium complex (DMAC) infection to the morbidity and mortality of patients with acquired immune deficiency syndrome (AIDS) is unclear. Previous studies that suggested the decreased survival of patients with AIDS and DMAC had incomplete information on patient immunologic status and follow-up. We studied patients with AIDS and DMAC and compared their survival with that of AIDS patients without DMAC but with other comparable risk factors for survival. Case and control subjects were similar in terms of CD4 cell count, prior AIDS status, history of antiretroviral therapy, history of Pneumocystis carinii prophylaxis, and year of diagnosis. A group of 39 patients with untreated DMAC had significantly shorter survival, mean of 5.6 +/- 1.1 months (median 4 months), than 39 matched patients with AIDS but without DMAC, mean 10.8 +/- 1.3 months (median 11 months, p less than 0.0001). The survival of 16 additional patients with DMAC who received antimycobacterial therapy, mean of 9.5 +/- 1.4 months (median 8 months), was not significantly shorter than that of an additional 16 matched control subjects, mean 11.7 +/- 1.9 months (median 11 months, p = 0.58). Patients with treated DMAC survived significantly longer than those with untreated DMAC (p less than 0.01). We conclude that untreated DMAC significantly shortens survival. Moreover, these results indicate that patients with DMAC who receive antimycobacterial therapy do not experience the shortened survival seen in untreated DMAC.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Evaluation of conscious sedation in facial plastic surgery.

Local anesthesia and conscious sedation are important aspects of facial plastic surgery. The safe and effective application of these techniques is important to produce happy, satisfied patients as well as good surgical results. Local anesthetic and sedative drugs will be discussed with respect to their mechanisms of action, doses, toxicities and appropriate selection. We will discuss the techniques we have developed using fentanyl and Versed and our evaluation of their effectiveness. Twenty sequential facial plastic surgical patients undergoing a total of 30 procedures will be reviewed. The average dose of fentanyl was 70 mcg and Versed was 3.1 mg. Significant amnesia occurred in 60% of patients, 80% experienced little or no discomfort and 90% would have no hesitation to undergo another procedure with similar anesthesia and sedation.

Anesthesia, Local↗
PubMed1991

Analysis and correction of the crooked nose.

The crooked nose is defined as a nose in which the midline is off center without tissue loss. This leaves a nose that is angulated at the nasion or the rhinion. Surgical correction with angulation of the nasion includes medial osteotomies, two transverse oblique osteotomies, one transverse root osteotomy and one lateral osteotomy. Angulation at the rhinion includes separation of one upper lateral cartilage from the septum, shortening of one upper lateral cartilage, weakening of the dorsal strut with a double cut technique and resuturing the upper lateral cartilage septal complex back together.

Humans↗
PubMed1990

A prospective study of genital infections in a family-planning clinic. 2. Chlamydia infection--the identification of a high-risk group.

During a study of genital infection in inner-city family-planning patients we examined 452 women for Chlamydia trachomatis. The prevalence of infection was 7.3%. There was no significant difference between patients attending because of genital symptoms and those who were attending for routine family-planning advice. Infection was found to be correlated with five main demographic parameters; age less than 25, no stable partnership, hormonal contraception, nulliparity and West Indian Ethnic origin. Using these parameters a simple scoring system was devised which allowed a high-risk population to be defined in whom screening would be economically justified.

Adult↗
PubMed1990

The ideal tissue adhesive in facial plastic and reconstructive surgery.

In this paper we have reviewed cutaneous wound closure in facial plastic and reconstructive surgery using two different tissue adhesives: (1) Fibrin glue (Tisseel), and (2) N-butyl-2-Cyanoacrylate (Histoacryl Blue). Fibrin glue was used on 23 patients: eight lower blepharoplasties, eight hemi-facelifts, five mid browlifts and seven facial reconstructive procedures. Histoacryl glue was used in 108 blepharoplasty incisions, 30 facelift incisions, 21 submental incisions for liposuction, and 19 local flaps for facial reconstructive procedures. Comparison was made of the adequacy of bonding, cosmetic result of the incision, ease of use and cost. The results of our experience with tissue adhesives indicate the use of fibrin glue mainly on the undersurface of flaps. We think histoacryl glue is the ideal tissue adhesive for surface cutaneous wound closure in regards to safety, reliability, tensile strength and cost effectiveness.

Enbucrilate↗
PubMed1989

The effect of facial animation on the aging upper half of the face.

Sixty patients, ranging in age from 29 to 74 years, were studied for the effect of animation of the upper half of the face on the aging features. Patients were divided into three categories according to the dominant behavioral pattern: brow lifters, frowners, and squinters. Brow ptosis was accentuated laterally in the squinters and medially in the frowners. The brow-lifter group showed more uniform displacement of the eyebrow. The coarse wrinkles or the animation lines also correlated well with the animation pattern. These patterns are acquired in childhood and remain subconsciously in effect throughout adult life and therefore have a significant effect on brow ptosis.

Adult↗
PubMed1988

Fibrin glue in facial plastic and reconstructive surgery.

Fibrin glue has gained extensive use in Europe in the past decade but remains fairly new to North America. Fibrin glue physiology, its historical background, experimental findings, its present uses and the question of safety are addressed. Results of its use in facial plastic and reconstructive surgery at the Toronto Western Hospital are presented. The authors conclude that fibrin glue is a safe bioadhesive and sealant. It is an excellent adjunct but not a substitute for good surgical techniques.

Adult↗