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Biomedical subjects

I T Jackson

Publications and source records attributed to I T Jackson.

At least 127 records · Page 7Linked to original sources
PubMed1989

Use of contoured and stabilized conchal cartilage grafts for lower eyelid support: a preliminary report.

Lower lid stability can be affected by many conditions involving the lid directly, e.g. facial palsy, facial clefts, trauma, or tumors. Secondary stretching due to a poorly fitting orbital prosthesis can have the same effect. In 41 such eyelids, stability was obtained by inserting a large cartilage graft sutured to the tarsal plate and the infraorbital rim. Thirteen patients had tarsoconjunctival wedge resections, and 10 had lateral canthopexies performed at the same procedure. One graft was too small and was later replaced. There was one hematoma, which was evacuated. There were no other lid or visual problems. The follow-up is short, 21 months maximum, but so far the results are very satisfactory.

Cartilage↗
PubMed1989

The management of intraosseous arteriovenous malformations in the head and neck area.

It is necessary that the treatment of arteriovenous malformations in general be undertaken by a team that consists of a radiologist who is experienced in angiography and embolization and a plastic surgeon. The latter should be well versed in angiographic techniques and should be able to comprehend the dynamics of these malformations. In this report, three patients with high-flow, high-shunt arteriovenous intraosseous malformations of the head are presented. Two of these presented as emergencies with almost uncontrollable bleeding and were initially treated with embolization and then mandibular resection and reconstruction within the first 48 hours. In one patient, a further reconstructive procedure using free vascularized tissue was carried out. A third patient with involvement of the maxilla, again presenting with bleeding, was treated with embolization and, because of the deformity that would be created by resection, was simply observed. However, this patient is to be reassessed in the future and may well come to maxillectomy. It is emphasized that the treatment of these patients requires careful assessment, embolization, and resection as indicated after discussion between radiologist and surgeon.

Adolescent↗
PubMed1989

Distichiasis and cleft palate.

A patient with the unusual coexistence of distichiasis and cleft palate is described. Distichiasis is a rare congenital eyelid anomaly in which accessory eyelashes are present in the meibomian gland orifices. Its association with other systemic abnormalities is reviewed; the distinctions among distichiasis, trichiasis, entropion, and epiblepharon are outlined; and methods of treatment for distichiasis are described.

Abnormalities, Multiple↗
PubMed1989

A significant feature of Nager's syndrome: palatal agenesis.

Nager's syndrome, which has the facial features of Treacher Collins syndrome, preaxial upper limb defects, short stature, and frequently subnormal intelligence, is very rare. Five new cases have been collected. In four, there was virtually total absence of the soft palate. This has been described in two patients in the past. Differing methods of correcting this are presented.

Child, Preschool↗
PubMed1989

Surgical treatment of thyrotoxic exophthalmos.

Conservative treatment of thyrotoxic exophthalmos has not given satisfactory results. Our observations, modifications of the standard surgical technique, and the results of orbital decompression for this condition are presented. Through a transverse incision close to the lower eyelid margin, the floor and the lateral orbital wall are explored. The posterior part of the orbital floor and the zygomatic part of the lateral orbital wall, as well as the periorbital fat, are removed. Through an incision made over the medial margin of the orbit, the medial orbital wall is explored and its ethmoidal part is removed. By the same approach, further retrobulbar fat is removed. Through an upper eyelid incision, fat is removed from the eyelid region and the levator aponeurosis is divided. This produces satisfactory symmetrical decompression of the orbit with good correction of exophthalmos and a significant decrease in the signs and symptoms of this condition.

Adipose Tissue↗
PubMed1989

Gigantic mammary hyperplasia in pregnancy associated with pseudohyperparathyroidism.

This is the first report of hypercalcemia due to benign gigantic mammary hyperplasia in a pregnant women. Endocrinologic examinations did not disclose any known cause for the symptomatic hypercalcemia. Bilateral total mastectomy decreased the serum calcium level to normal. The case is presented with discussion and a literature review.

Adult↗
PubMed1989

Classification and treatment of orbitozygomatic and orbitoethmoid fractures. The place of bone grafting and plate fixation.

The classification of orbitozygomatic fractures is presented, and, using this, a decision can be made as to when to examine the fracture with CT scans and how to decide on employing a coronal approach for exposure. Three-point fixation is advocated using wires and miniplates. All portions of the fracture should be stabilized. In this way, the complications of enophthalmos, diplopia, dystopia, and flattening of the nose and cheek may be avoided. The method of treating late deformity resulting from orbitozygomatic and orbitoethmoid fractures is presented, stressing wide exposure, good fixation of osteotomies with miniplates, and cranial bone grafting to reduce orbital volume and correct enophthalmos.

Bone Plates↗
PubMed1989

Infections in breast implants.

Infection following breast implants is an uncommon event. This is somewhat surprising, since the human breast is not a sterile anatomical structure. The flora found in the breast are derived from the nipple ducts and closely resemble those of normal skin. These organisms, predominantly S. epidermidis, may in some cases be responsible for firmness secondary to capsular contracture. Treatment of the periprosthetic infection usually involves implant removal, but salvage by systemic antibiotics is sometimes possible. Atypical mycobacteria are very rarely the cause of infection, but can be extremely difficult to eradicate when involved. Toxic shock syndrome has been reported to occur following breast implants and is a life-threatening problem requiring immediate removal of the implant. It may be significant that in some cases with effusion and infection occurring many months or years after implant placement, there has been a preceding event such as a laryngitis or flu-like illness. This suggests the possibility of a bacteremia being involved in the causation of the infection. If this were the case, then these patients should be handled in a fashion similar to those with prosthetic heart valves. Accordingly, in our own practice, we advise that penicillin "V" be given beforehand when a patient with breast implants is to have any dental procedure. It must be stressed that there is no statistical or scientific proof at the present time that this is of any value. In conclusion, when dealing with these large foreign bodies, absolute sterility is essential, and excellent surgical technique to obviate hematoma and the occurrence of tissue ischemia is mandatory. Evidence of severe infection necessitates implant removal, but in less severe cases a trial of intravenous antibiotics is permissible. Having removed an implant, further insertion should be deferred, preferably for 6 months. If the new implant can be placed in a different plane, that is, submuscular, this is desirable. Exposed implants can be salvaged but this requires considerable judgment and one should be prepared for re-exposure or frank infection.

Bacterial Infections↗
PubMed1989

The fate of buccal mucosal flaps in primary palatal repair.

The fate of buccal mucosal flaps used in 50 cases at the time of primary palatal repair is reviewed. It was found that in 13 cases (26 percent) the pedicle of the flap interfered with the eruption of the permanent molars and had to be divided. Nasendoscopic examination was made of the palate in 16 cases in an attempt to visualize the buccal flap. It was identified in only three cases. It is suggested that if this flap is to be used, it must be designed carefully, and that regular intraoral examination of the patients is required around the time of eruption of the permanent molars.

Adult↗
PubMed1989

Maxillary hypoplasia.

Maxillary hypoplasia and retrusion is complex. It may involve the dentoalveolar area, or it may involve the whole midface. It may be difficult to recognize, since the patient may come only with the complaint of nasal deformity, and the occlusion may be normal. It may be difficult to treat, as in the severe Binder's syndrome, where in addition to the bony deformity, the facial mask is deficient and obviously in the wrong position. To treat the condition the surgeon must have an aesthetic sense. It is not like the situation when only the maxilla is involved; this tends to be mechanical and is related to dental malocclusion. In these patients, an aesthetic appreciation of the nose and its relationship to the maxilla, infraorbital rims, and frontal area is paramount. Unless this complete approach is used, the patient will be undertreated and end up unhappy. Patients can readily appreciate the position and the contours of the nose, but they do not understand the subtleties of the lack of a bony foundation when there is maxillary hypoplasia. Not only does this involve a high degree of aesthetic appreciation on the part of the surgeon, it also necessitates a considerable ability to convey to the patients that the problem is not the simple one that they had first imagined. When all of these subtleties are appreciated, it is possible to develop a degree of sophistication in the treatment of these patients that will yield excellent results.

Humans↗
PubMed1988

Pseudohyperparathyroidism secondary to gigantic mammary hypertrophy.

Pseudohyperparathyroidism encompasses both ectopic hyperparathyroidism and the more commonly encountered nonparathyroid humoral hypercalcemia of malignancy--metastatic breast cancer being the classic example. Benign breast disease is a rare cause of hypercalcemia. We recently managed a patient with gigantic mammary hypertrophy that occurred during pregnancy who concomitantly manifested marked nonparathyroid hypercalcemia. This report strongly suggests that a casual relationship exists between benign breast disease and hypercalcemia.

Adult↗
PubMed1988

Experience with an external valve in small volume tissue expanders.

Tissue expansion has been a reconstructive technique for nearly 10 years. All published work has described serial expansion by percutaneous injection into a buried reservoir. This paper reviews a small series of patients who had tissue expansion using small volume expanders with an external valve. The complications with small expanders are discussed. The external valve is shown to be satisfactory and free from infection in this series.

Adult↗
PubMed1988

A new feature of the ablepharon macrostomia syndrome: zygomatic arch absence.

The ablepharon macrostomia syndrome is an extremely rare congenital anomaly. It is characterised by bilateral absence or hypoplasia of lower eyelids, macrostomia and multiple other congenital anomalies. Three cases have been reported (McCarthy and West, 1977; Hornblass and Reifler, 1985). In addition to ablepharon and macrostomia, other anomalies common to all patients include auricular deformity, nasal alar deformity, absence of lanugo hair, dry, ichthyotic skin and ambiguous genitalia. A new feature of the syndrome is described--absence of the zygomatic arches. In addition, an expanded and revised classification of the ablepharon macrostomia syndrome and related disorders is presented. Skin graft pigmentation in this black patient has been prevented by prolonged application of sun block.

Abnormalities, Multiple↗
PubMed1988

Orbital expansion in plagiocephaly.

In moderate to severe plagiocephaly, the transverse diameter of the orbit on the affected side is consistently decreased. In these cases, the supraorbital rim has been expanded by the required amount and bone grafted. This makes for greater orbital symmetry and ease in obtaining the correct supraorbital convexity. Ten patients have been handled in this way with satisfactory postoperative results.

Craniosynostoses↗
PubMed1988

A simple instrument for surgical tattooing and skin marking.

We describe here a reliable and inexpensive surgical marking instrument utilizing materials that are readily available. It can be used preoperatively or intraoperatively for tattooing points of reference in spite of vigorous preps.

Dermatologic Surgical Procedures↗