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Biomedical subjects

R E Wesley

Publications and source records attributed to R E Wesley.

At least 55 records · Page 3Linked to original sources
PubMed1983

Combined procedure for senile entropion.

Entropion of the lower eyelid was corrected in 26 eyelids of 21 patients. All patients were found to have a disinsertion of the capsulopalpebral fascia, but not Muller's muscle layer, of the lower eyelid retractors. All cases were repaired by reattaching the anterior edge of the capsulopalpebral fascia to the inferior edge of the lower tarsus combined with A horizontal eyelid tightening procedure performed at the lateral canthus. With follow-up of six to 32 months, no cases of entropion have recurred. We have found a combined procedure of horizontal eyelid tightening and repair of the capsulopalpebral fascia gives best long-term results.

Entropion↗
PubMed1982

Basal cell carcinoma of the eyelid as an indicator of multifocal malignancy.

Of 30 consecutive patients with ocular adnexal basal cell carcinoma, 18 (60%) had at least one additional unsuspected foci of basal cell carcinoma. The patients most likely to have additional basal cell skin cancer were women, those with previous basal cell carcinoma, and those whose eyelid lesions were recurrent, located at the medial canthus, or of the sclerosing cell type. Using a slit lamp helped us to identify suspicious lesions on the face, but we often required the assistance of a dermatologist to diagnose sclerosing lesions. Comprehensive treatment of basal cell carcinomas should include eradication of the initial lesion, examination for coexisting lesions, prophylaxis for solar exposure, and follow-up examinations for recurrent or new lesions.

Adult↗
PubMed1982

Tarsal ectropion from detachment of the lower eyelid retractors.

In 17 eyelids of 14 patients a disinsertion of the lower eyelid retractors from the lower tarsus was identified and repaired through the conjunctiva. The disinserted lower eyelid retractors were isolated in the inferior fornix with forceps, the redundant conjunctiva was excised, the lower eyelid retractors were reattached to the inferotarsal border, and the eyelid was tightened horizontally. During follow-up periods ranging from six to 26 months, there have been no recurrences and no cases of cicatricial entropion.

Adult↗
PubMed1982

Management of wooden foreign bodies in the orbit.

Three large wooden foreign bodies were undetected in the orbit despite extensive evaluation and orbital exploration. In two cases there was motility disturbance from orbital inflammation that resolved after late spontaneous extrusion of the foreign material. Recurrent fistula unresponsive to antibiotics persisted in two cases until the wood extruded. Computerized tomography and ultrasonography failed to identify the foreign material. Orbital exploration without preoperative localization of the foreign body is usually contraindicated because proptosis, motility limitation, and fistula usually resolve after late spontaneous extrusion. In our cases and in the literature early exploration did not lead to complete extirpation of foreign material. We inform the patient of our diagnostic limitations and the prudence of conservative management.

Adult↗
PubMed1982

Tension pneumocephalus from orbital roof fracture.

Despite the detection and treatment of an extensive orbitocranial fracture in an 18-year-old man following a motor vehicle injury, the persistent leakage of CSF and trapping of air within the intracranial cavity resulted in fulminant neurologic deterioration due to the mass effect of air when tension pneumocephalus developed. The ethmoidal defect closed spontaneously, and the patient recovered neurologically when the tension pneumocephalus was relieved with a ventriculoatrial shunt. Orbitocranial injuries, which may be unsuspected despite careful orbital, neurologic, and conventional roentgenographic examination, have a considerable mortality. The presence of intracranial penetration. The CT scans, which detect as little as 0.5 mL of intracranial air, can be used to document serial changes in amount or position of air and detect shifts of the brain. tension pneumocephalus following orbitocranial injury and management with ventriculoatrial shunting have not been previously reported.

Adolescent↗
PubMed1982

Pseudopterygium from exposure to selenium dioxide.

Pseudopterygium and symblepharon developed in a patient exposed to selenium dioxide gas. Previously, a case of pseudopterygium had been reported after exposure to seleniferous acid. This cicatricial condition can be distinguished from the pterygium by eccentric location, the lid scarring, and the absence of pterygium in the other eye. This pseudopterygium recurred despite 11 operations. Full-thickness mucous membrane grafts wee used to separate the lid from the globe.

Adult↗
PubMed1981

Use of air entrainment masks during eye surgery.

Plastic drapes over the patient's face during eye surgery are necessary to maintain a sterile surgical field. We found that providing the patient with adequate inspiratory gas under these surgical drapes was a problem. We now use air entrainment oxygen masks to provide this surgical patient with a high flow gas source, nearer to peak inspiratory flows than the previously used nasal cannula. The mask is powered with compressed air or, if necessary, compressed oxygen. This practice has helped eliminate restlessness, smothering sensations, coughing, and sudden movements, which can result in disastrous complications during ophthalmic microsurgical procedures. Respiratory therapists can play a key role in explaining and adapting this system for eye surgery.

Anesthesia, Local↗
PubMed1981

Cosmetic eye modified to retain vision.

A patient with bilateral ocular injuries with hypotony and light perception vision was fitted with scleral shells modified to allow light to pass through the central 4-mm area. This modification, allowing the patient to retain light perception with the prosthesis in place, aided in the rehabilitation of this patient by encouraging his independent ambulation, providing clues to time, place, and direction, and offering an enhanced cosmetic effect.

Adult↗
PubMed1981

Use of venturi entrainment mask for high-flow ventilation of patients submitting to ophthalmic surgery under local anesthesia.

The venturi entrainment mask is an inexpensive, disposable item readily available from the respiratory therapy department of most hospitals, which can be used with the patients submitting to ophthalmic surgery under local anesthesia to provide low oxygen concentration, high-flow ventilation at nearly room temperature and humidity. Four liters of oxygen will entrain an additional 101 liters of room air using the 24% uptake valve. This high-flow ventilation system eliminates hypercarbia since the patient never rebreathes. The mask elevates the drapes comfortably off the patient's face without dislodging and reduces the danger of flash fire with the use of thermal electrocautery.

Anesthesia, Local↗
PubMed1980

Height of the tarsus of the lower eyelid.

The vertical height of the lower eyelid tarsus of 20 patients submitting to lower eyelid resections and the lower tarsus of 17 cadavers was 3.7 mm (+/- 0.3) and 3.9 mm (+/- 0.5), respectively. The average value found in our patients was statistically different (P less than .05) than the values of 5 to 7 mm reported previously. The lower tarsus should be clearly identified in procedures involving eyelid repair or eyelid reconstruction so that tension-bearing sutures can be placed through the tarsus.

Adult↗
PubMed1980

Soft tissue intranasal foreign bodies.

Soft tissue intranasal foreign bodies usually present as a well-defined syndrome in children 1 1/2 to 3 years of age who develop a chronic unilateral, purulent, fetid, unexplained rhinorrhea because the foreign material is not discovered in the nose on routine examination. Four cases are presented to document for the first time the anatomic location of soft tissue intranasal foreign bodies which become lodged in the anterior-superior aspect of the nasal cavity between the anterior edge of the middle turbinate and the bridge of the nose. No recurrence has been noted following removal of this material with the hemostat advanced superiorly inside the anterior border of the nose. One case with persistent rhinorrhea developed pneumonia and generalized body odor.

Female↗
PubMed1980

Superior oblique paresis after blepharoplasty.

A case of superior oblique paresis is presented which appeared to be due to cautherization of the superior oblique tendon. The torsional diplopia and head tilt were corrected with recession of the contralateral inferior rectus muscle.

Adult↗
PubMed1979

Acute myocardial infarction after fluorescein angiography.

A 68-year-old man with a history of previous myocardial infarction and peripheral vascular disease had an acute myocardial infarction 30 minutes after the injection of intravenous fluorescein for fundus angiography. The situational stress or phenylephrine dilating drops could have contributed to the complication.

Acute Disease↗