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Biomedical subjects

F Ortiz-Monasterio

Publications and source records attributed to F Ortiz-Monasterio.

At least 19 recordsLinked to original sources
PubMed2004

Management of the impaired adult cleft patient: the last chance.

OBJECTIVE: Unfortunately, not all patients receive the benefits of a well-trained, experienced, multidisciplinary cleft team, and a significant number of patients reach adulthood with severe neglected cleft related problems. The vast majority of this group have made their way through several surgical procedures, usually performed by different surgeons in different centers, and still carry the original cleft stigmata aggravated by variable degrees of maxillary hypoplasia, fistulae, scarring, muscle pull, soft tissue tension, lost teeth, dental adaptation, and instability of bony fragments. Adult patients who reach this stage with their original deformities have, in most instances, lost their best opportunity to be properly treated. With this assumption in mind, an aggressive surgical plan focused mainly on the deformities that can objectively achieve functional and aesthetical improvement should be individualized for each patient. In this article, experience with 38 consecutive adult patients with cleft managed following a two-stage protocol used at our cleft clinic for the last 4 years is presented. CONCLUSION: An algorithm to help definitively solve these deformities is suggested.

Adult↗
PubMed2001

Fibreoptic nasal intubation in children with anticipated and unanticipated difficult intubation.

The establishment of a tracheal airway with direct laryngoscopy can be either a very difficult or an impossible task in children with congenital or acquired facial malformations. Out of 46 patients categorized as difficult tracheal intubation, fibreoptic laryngoscopy was used successfully in 44 children anaesthetized by mask with sevoflurane and oxygen or by an intravenous infusion of propofol and mask oxygenation. There were two failures (4.3%). One was due to excessive bleeding and secretions produced by the multiple attempts to intubate with direct laryngoscopy and the other failure in a patient with Pierre Robin syndrome and very small nasal passages that precluded the introduction of the endoscope. Fibreoptic laryngoscopy was successful in 37 cases (80.4%) on the first attempt to intubate and in seven (15.2%) on a second or third attempt. We conclude that fibreoptic laryngoscopy in anaesthetized children with difficult anticipated or unanticipated tracheal intubation in trained hands is a safe technique that can be lifesaving. Therefore, we urge all anaesthesia trainees to become proficient in fibreoptic tracheal intubation.

Adolescent↗
PubMed1998

Endoscopic dissection of dura and craniotomy with minimal trephines: a preliminary series.

The first nine clinical cases using endoscopic dissection of dura and craniotomy with minimal trephines were performed from June to August 1997 after trial dissection of 19 fresh cadavers conducted at the University of Brno's Pathology Institute in the Czech Republic. These procedures involved the refinement of craniofacial and intracranial surgical techniques using the endoscope and prototype instruments. These dissections demonstrated that intracranial structures can be explored using an endoscope without encumbrance, and that major craniofacial surgeries may also be performed with minor incisions and minimal craniotomies. Furthermore, we seek to illustrate that use of the endoscope in craniofacial surgery provides improved visualization and protection of vital structures while simultaneously allowing the surgeon to perform delicate maneuvers. This permits minimal brain retraction with less subsequent morbidity. This minimally invasive craniofacial-intracranial surgical technique using the endoscope is performed with minimal cutaneous incisions, avoiding wide exposure of subcutaneous tissue, cranium, and meningeal structures. The ultimate goal is to perform endoscopic intracranial osteotomies and obtain advancement of craniofacial skeleton with gradual distraction. Potential neurosurgical advantages include improved postoperative recovery, decreased cerebral edema, and decreased risk of hemorrhage and infection.

Child↗
PubMed1998

[Bone substitute with growth factor. Preliminary clinical cases for cranio- and maxillo-facial indications].

Several biological materials have been analyzed in combination with osteo-inductive growths factors to determine whether such a system can replace bone grafting in surgical practice. Efforts have been aimed at the discovery of the best carriers and delivery systems. We present the results of the surgical treatment of 11 cranio-maxillo-facial defects in 9 patients using a combination of natural coral skeleton (NCS in blocks or granules), human fibrin glue and transforming growth factor beta-1 (TGF-beta 1) as a composite bone substitute. Three patients were initially excluded because of early extrusion of the materials due to a technical error. Clinical and radiological evaluation was performed in all cases, with the patient acting as his own control. Clinical firmness and radiological mineralization occurred in three quarters of cases. New bone formation was confirmed histologically in two of these patients. Clinically the initial results remained stable over a three years follow-up with staged surgical procedures performed on a number of patients. None of the patients suffered any detrimental effect from implantation of the bone substitute. Although the numbers in these series are limited, the association of TGF-beta 1, human fibrin glue and NCS represented an interesting step, although the clinical results could be improved. Important factors in the success of this technique appeared to be stabilisation of the biological materials, quality and asepsis of the surrounding tissue and the dose of growth factor.

Acrocephalosyndactylia↗
PubMed1996

Recovery of congenital facial palsy in patients with hemifacial microsomia subjected to sural to facial nerve grafts is enhanced by electric field stimulation.

The effect of electric field stimulation for promoting axonal growth between sural to facial nerve grafts in cases of congenital permanent facial palsy associated with hemifacial microsomia was studied. For this purpose, a total of 17 patients with unilateral congenital permanent facial palsy associated with hemifacial microsomia were studied pre- and post-operatively. A sural to facial nerve graft was performed in all cases and long term postoperative electric field stimulation was randomly applied to half of the patients. Although improvement occurred in both groups, the results indicated that clinical and electrophysiological recovery was significantly better in patients receiving post-operative electric field stimulation. The results, therefore, suggest that electric stimulation of the grafted area induces improvements of facial palsy over and above those observed in the non-stimulated patients.

Axons↗
PubMed1994

Transnasal approach to the orbit, the interorbital space, and the nasopharynx.

We present a surgical procedure that provides exposure to the medial part of the orbit, the interorbital space, and the nasopharynx. A midline incision of the nose is followed by a pedicled osteotomy of the lateral nasal wall and the medial wall of the orbit in one piece. This transnasal approach provides good exposure to the medial parts of the craniofacial junction to remove foreign bodies or benign tumors.

Angiofibroma↗
PubMed1994

Orbital hypertelorism.

Excessive distance between the orbits is only one manifestation of a complex deformity that affects several skeletal and soft-tissue structures. This article discusses the classification, preoperative planning, and surgical procedures used in the reconstruction of orbital hypertelorism.

Adult↗
PubMed1993

Early postnatal treatment of congenital facial palsy in patients with hemifacial microsomia.

Facial palsy associated with hemifacial microsomia results in a devastating deformity. To date, no attempts on early treatment of the associated facial palsy have been reported. A therapeutic approach may be to provide reinnervation to the affected muscles through a crossed facial nerve graft. The purpose of this paper is to present 8 cases of hemifacial microsomia with associated facial palsy. All these patients were treated before 1 year of age with cross-sural-to-facial nerve grafts. After a 1 year follow-up, clinical and electrodiagnostic results indicate axonal continuity through the graft and evidence of reinnervation activity in all patients. Crossed facial nerve grafting appears to be an adequate procedure in patients with hemifacial microsomia with associated facial palsy.

Action Potentials↗
PubMed1992

[Treatment of congenital facial paralysis with crossed innervation of facial nerve and electric field stimulation].

Congenital facial palsy is a devastating deformity. At present time there are no reports of the early treatment of this disorder. The treatment may be to supply contralateral auto reinnervation to the affected muscles through a sural-facial nerve graft enhanced by electric field stimulation. The purpose of this paper is to report 5 cases of congenital facial palsy treated by a crossed sural-facial nerve graft, enhanced by electric field stimulation. One year after surgery, clinical and electrodiagnostic examinations indicate appropriate reinnervation activity in all the patients.

Combined Modality Therapy↗
PubMed1985

Lateral canthoplasty to change the eye slant.

A technique is described to modify eyelid slanting and correct excessive scleral show. The anatomic relations of the canthal ligament with the fibrous supporting structures of the eyelid are discussed. The procedure is indicated in aesthetic surgery, in congenital anomalies, and in sequelae of trauma.

Adolescent↗
PubMed1981

The use of cartilage grafts in primary aesthetic rhinoplasty.

Our experience with the use of cartilage grafts in 430 primary rhinoplasties is presented. We find grafts indicated when operating on small noses with thick skin to increase and define the dorsum, to add projection and angularity to the tip, to project the columella, and to correct the acute nasolabial angle. The procedure is technically simple and relatively free of complications. Long-term evaluations show no absorption of the grafts and preservation of the desired shape.

Cartilage↗