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Biomedical subjects

R G Small

Publications and source records attributed to R G Small.

At least 37 records · Page 2Linked to original sources
PubMed1988

Upper eyelid retraction in Graves' ophthalmopathy: a new surgical technique and a study of the abnormal levator muscle.

A new surgical procedure, the proximal levator technique, achieves recession of the retracted upper eyelid in Graves' ophthalmopathy by sectioning the levator muscle proximal to Whitnall's ligament and fixing eyelid position with sutures that permit postoperative adjustment. This technique deserves further study. Enlargement of the proximal levator muscle in Graves' eye disease is shown on orbital CT scans and is found at surgery when the proximal levator technique is employed. Histologic and morphometric studies demonstrate increased levator muscle fiber size as well as increased extracellular volume. These findings suggest that levator muscle hypertrophy is important in the pathogenesis of upper eyelid retraction in Graves' ophthalmopathy.

Adolescent↗
PubMed1985

A new upper blepharoplasty clamp.

New right and left blepharoplasty clamps have been devised which conform to the three-dimensional curves of the adult upper eyelids. These are suggested for use in older patients who require excision of a large amount of skin and are an adjunct in upper blepharoplasty. We have used the new clamps successfully in 20 upper blepharoplasties. The clamps provide for a rapid, bloodless removal of large amounts of skin.

Equipment Design↗
PubMed1984

Carbon dioxide laser blepharoplasty.

An experience utilizing the carbon dioxide laser for blepharoplasty in a series of 40 patients with an average follow-up of 16 months is reported. The advantages of this method include improved control of intraoperative hemorrhage which occurs because the laser cauterizes small vessels as it cuts tissues. Postoperative ecchymosis and edema are minimal and early rehabilitation occurs. Complications and technical disadvantages are discussed, concluding that the carbon dioxide laser offers a safe alternative with some distinct intraoperative and postoperative advantages to conventional blepharoplasty surgery.

Blepharoptosis↗
PubMed1983

Custom ocular prosthesis with dilating pupil.

The manually adjustable pupil has two diameters: one constricted, the other dilated. The patient may select the appropriate diameter for the existing light conditions by moving a small magnet over the surface of the prosthesis. In the discerning patient this prosthesis will eliminate the need for two separate prostheses, which are commonly provided today. Patient privacy and hygiene are maintained because the prosthesis need not be removed to alter pupil size.

Eye, Artificial↗
PubMed1983

Exenteration of the orbit in selected cases of severe orbital contracture.

Severe orbital contracture is treated with graft-covered conformers fixed to the orbit with wires, pins or a headcap. In spite of these vigorous techniques, failures occur. Exenteration was used in four cases of severe orbital contracture with deformity and restricted function of the eyelids. The patient was fitted in six to eight weeks with a prosthesis made from methyl methacrylate and silicone. The margins of the prosthesis were inconspicuous in contrast to older prostheses made entirely of methyl methacrylate. The flexible silicone was well tolerated by the skin of the orbital margins. Patient acceptance and cosmetic appearance has been excellent.

Adult↗
PubMed1981

Extended lower eyelid blepharoplasty.

The extended lower eyelid blepharoplasty involves the use of a large myocutaneous flap dissection well down over the zygoma. This has been found useful in eliminating large edematous bags over the cheek. It also is useful in lower eyelid blepharoplasty in selected cases of thyroid disease, orbital reconstruction, facial trauma, and certain other reconstructive procedures. This procedure was used on 43 eyelids in 24 patients.

Adult↗
PubMed1981

A combined orbital and antral approach to surgical decompression of the orbit.

A combined orbital decompression procedure has been found effective in treating proptosis. The procedure includes a lower eyelid incision by an ophthalmologist to expose the floor of the orbit, while a Caldwell-Luc antrotomy is performed simultaneously by an otolaryngologist. The ophthalmologist has a better view of the contents of the orbit and the anterior orbital floor. The otolaryngologist has better access to the posterior orbital floor and ethmoid sinus. Together, isolation and preservation of the second division of the fifth cranial nerve are facilitated. The headlight worn by each surgeon helps illuminate the other's field of dissection. This combined approach offers advantages over separate operations.

Adult↗
PubMed1981

Orbital exenteration--simplified.

In summary, a simplified technique of orbital exenteration has been presented. Results, with complications, in eleven cases have been described. The advantages of the operative method described are: (1) full thickness skin provides better cushion for self-retaining prosthesis, (2) skin with intact blood supply is much less likely to be rejected, (3) no donor site with added discomfort and care, (4) local recurrence of neoplasm is easily detected, (5) operating time shortened and (6) favorable patient acceptance.

Adult↗
PubMed1980

The A-frame operation for acquired blepharoptosis.

The A-frame operation has been found effective in the treatment of acquired blepharoptosis. It has the following advantages: (1) it can be done easily, rapidly, and if desired, bilaterally, with a minimum of dissection; (2) corneal irritation is not seen; (3) the tarsus is not disturbed; (4) since it is done through an external incision, it can be done with a concomitant blepharoplasty or other oculoplastic procedure; and (5) the procedure is easily learned. The operation is a block resection of levator aponeurosis, Müller's muscle, and conjunctiva. The term "A-frame" was adopted from the use of temporary traction sutures to pull up the layers to be resected, suggesting an A-frame building. The results in 40 eyelids are presented with two illustrative case histories.

Aged↗
PubMed1979

A milk-borne outbreak due to Salmonella dublin.

Salmonella dublin is primarily adapted to bovines and is a relatively rare cause of human illness. An outbreak is described in which it was estimated that at least 700 persons were infected from milk which had not been subjected to heat treatment. Although the organism was isolated from retail samples of milk, investigations at the dairy farm were inconclusive and a number of questions are posed. Attention is drawn to the value of inter-disciplinary cooperation in the investigation of the outbreak.

Adolescent↗
PubMed1978

Supratarsal fixation in ophthalmic plastic surgery.

The use of supratarsal fixation in ophthalmic plastic surgery is discussed. New anatomical terms for the external upper eyelid are described. Technique, complications, and illustrative cases are presented.

Blepharoptosis↗
PubMed1978

Congenital medial canthal tendon malposition.

This report describes the characteristics and treatment of a syndrome in which the predominant ophthalmic defect is a congenital malposition of the medial canthal tendon. The syndrome is illustrated by 3 patients, each of whom had associated nasal deformities on the ipsilateral side. These congenital anomalies most likely resulted from an arrest in development during the second month of embryonic life. A combined effort by the ophthalmic plastic surgeon, the general plastic surgeon, and the otolaryngologist has been found useful in the management of these patients.

Coloboma↗