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Biomedical subjects

J M Piffaretti

Publications and source records attributed to J M Piffaretti.

At least 19 recordsLinked to original sources
PubMed2004

[Etiology of eyelid edema].

Lidedema can be a common symptom of diseases of the orbital part of the face. One can differentiate lidedema in two groups, those that are related to an inflammation and those that are not related to an inflammation. Lidedema of the eyelid can also be secondary to a systemic disease. There is also another group that is common in the ageing population that consists of blepharochalasis and dermatochalasis where the skin becomes loose with the years and forms redundant folds.

Blepharitis↗
PubMed2001

Lid retractors desinsertion in acquired ptosis and involutional lower lid entropion: surgical implications.

BACKGROUND: An association exists between upper and/or lower lid retractors' desinsertion and acquired ptosis and/or involutional lower lid entropion. METHOD: By highlighting the similarities that exist in the anatomy of the upper and lower lid retractors a possible pathophysiological mechanism leading to acquired ptosis and involutional lower lid entropion is suggested. As a logical consequence, in case of desinsertion, it is proposed to reattach the lid retractors to the tarsus. RESULTS: With this simple "physiological" surgical approach it is possible to treat with success a great majority of acquired ptosis and/or involutional lower lid entropion. CONCLUSION: Repairing upper and/or lower lid retractors' desinsertion can cure acquired ptosis and/or involutional lower lid entropion.

Aged↗
PubMed2001

Lacrimal drainage system endoscopic examination and surgery through the lacrimal punctum.

BACKGROUND: To describe an approach to restore the physiological tear passages of an obstructed lacrimal drainage system with instruments introduced through one of the lacrimal punctum. METHOD: In a first step a miniature endoscope (Ø: 0.9, 1.1, 1.3 mm) is introduced in one of the lacrimal punctum to visualize the level, the extent, and the nature of an obstruction along the lacrimal drainage system. In a second step, the miniature endoscope is replaced by a lacrimal trephine (Ø: 0.9, 1.1, 1.3 mm) that holds an optic fiber in its lumen, and the obstruction is removed under endoscopic visual control. The entire procedure is performed under local anesthesia. RESULTS: With this approach it is possible to visualize and remove partial or total fibrous obstructions along the lacrimal drainage system (lacrimal canaliculus, nasolacrimal duct). Lacrimal sac lithiasis can also be fragmented and eliminate in the nose through the nasolacrimal duct. During or after the procedure only minor, and no major, complications can sometime occur, such as hematoma or edema (after lacrimal irrigation) of the surrounding soft tissues. CONCLUSION: The approach described here is straight forward, quick, and can be performed under visual endoscopic control and in local anesthesia. With this approach partial stenosis can easily be diagnosed and cured. This procedure might potentially change our current concepts regarding surgical indications for obstructive epiphora and dacryocystitis. However, the long-term results of this type of surgery need to be challenged.

Dacryocystorhinostomy↗
PubMed2001

[Masquerade of sebaceous gland carcinoma as a rapidly recurring "chalazion", a case report].

PURPOSE: Demonstration of the importance of surgical excision and histological examination in presence of an apparently harmless tumoral alteration of the eyelids. CASE PRESENTATION: We report the case of a 65 year old patient suffering from systemic lupus erythematosus who noted a tumoral lesion on his left lower eyelid. Suspecting a chalazion, his dermatologist simply performed a cauterization. Six weeks later, a recurrence of the tumor appeared at the same location, and again, cauterization was done. A few weeks later, the patient consulted our clinic with a polycyclic tumor of 5 mm in diameter, involving the lid margin of the temporal part of the lower left eyelid. The patient had only moderate signs of blepharitis. There were no palpable preauricular and cervical lymph nodes. Suspecting a malignant tumor, the entire tumoral lesion was removed surgically. HISTOPATHOLOGY: The histopathologic examination showed a highly differentiated sebaceous gland carcinoma, most probably originating from a meibomian gland. The margins of the excision were found to be tumor-free. DISCUSSION: Sebaceous cell carcinoma is a rare entity. Depending on its histological differentiation it can be highly malignant. Infiltrative, and can metastasize. The mortality may reach 30% if low differentiation is present. As illustrated in the present case, the lesion may masquerade a chalazion. Therefore, in case of atypical lesion of the eyelid region complete surgical removal followed by a histopathological examination should be performed.

Adenocarcinoma, Sebaceous↗
PubMed1985

[Iatrogenic teflon granuloma of the eyelid. (Teflon paste, an unsuitable filling material for plastic eyelid surgery)].

A paste of granular Teflon was injected into the upper lid of a patient for remodeling the upper palpebral furrow, which had been retracted by scars. Large foreign-body granulomas developed a few weeks later, necessitating two excisions. The causes of this unsatisfactory result with a filling material which is well established in laryngeal surgery are discussed. The authors advise against using it in well vascularized loose tissue.

Adult↗
PubMed1981

[Surgical treatment of senile entropion and ectropion of the lower lid (author's transl)].

a) Entropion: When developing or discussing a surgical technique one should try to understand how senile entropion develops. On the basis of clinical observation we can develop a suitable surgical technique from our knowledge of atonic (never spastic) entropion. The technique is described and results discussed. b) Ectropion: Clinical observations indicate two distinct causes of pathology: either elongation of the tarsus or loosening at the points of attachment. The surgical technique should be adapted on the basis of this observation. Surgical methods are discussed.

Aged↗
PubMed1980

[Indication for tarsorrhaphi in lagophthalmos].

Tarsorrhaphy is at present rarely indicated in lagophthalmos surgery. Newly developed techniques give at least as much protection to the eye as tarsorrhaphy and are clearly preferable cosmetically. Tarsorrhaphy continues to be indicated in transient facial pareses.

Eyelid Diseases↗
PubMed1979

[Stereoscopic photography in plastic surgery (author's transl)].

A major problem in reconstructive and plastic surgery of the face is the assessment of exact distances between certain points of reference across facial contours. Incorrect estimation of these variables produces unsatisfactory postoperative anatomical results. Therefore a method, which permits exact measurements using stereoscopic photography of models, was tested. On the models quantitative studies of the effects of surgical techniques were made. Facial asymmetry and various phases of facial animation can be assessed and documented, and the progress of expanding tumours can likewise be followed.

Adult↗
PubMed1979

[Problems of surgical therapy after irradiation for tumors of the eyelids (author's transl)].

UNLABELLED: We discuss 10 consecutive cases which have had surgery after irradiation for tumors of the eyelids. CONCLUSIONS: Reasons for surgical treatment after irradiation: 1. Relaps within the irradiated area. Conditions of tissue prohibit additional irradiation. 2. No effect of irradiation. 3. Relaps in deeper layers or further growth, not noticed during irradiation. Additional irradiation ruinous for the eye. - Surgical problems after irradiation: 1. Inadequacy of usual techniques. 2. More extensive surgery then primary excision of tumor.

Basal Cell Carcinoma↗
PubMed1978

[Problems of conjunctival closure after fornixplasty (author's transl)].

In plastic operations of the fornix the most important part of the reconstruction in cases without defect of the subconjunctival planes is to cover the defect with a plastic to make impossible the formation of symblepharon and to permit the spontaneous epithelialisation of the fornix. We operated on seven patients with this method and we always obtained very good fornix.

Adult↗
PubMed1975

[Specific pathological findings in trabeculectomy].

A quick embedding method for trabeculectomy specimens is desirable. It allows a comparison between the observations made during surgery and the histological material as long as the facts are remembered by the surgeon. Embedding by butoxy-ethanol-glycol-methacrylate proved to be adequate. It allows 1- to 2-mu thick sections. 39 trabeculectomy specimens were investigated in regard of topographical origin. In 26 of them, an exact localization was possible. Only 8 pieces contained Schlemm's canal or major parts of it. The others where cut more anteriorly and contained cornea and parts of the trabecular meshwork. The different topographical localization of the ectomized pieces did not influence the regulation of the intraocular tension in the early follow-up period. It is suggested that trabeculectomy does not give direct access to the aqueous to the cut ends of Schlemm's canal and to collector channels but rather by letting filter the aqueous externally along the scleral openings.

Aged↗