Biomedical subjects
Publications and source records attributed to S J Aston.
Normal and abnormal effects of aging impact greatly on individuals and their families. Health care providers must therefore be knowledgeable about how to care for elderly persons. In order to interact among elderly persons and within the aging network, optometrists need to have a broad understanding of gerontology.
Information on the geriatric patient is needed in the curricula of all health professional programs. During the 1988 Academy Meeting a Symposium on the Graying of America: Optometric Considerations, was held. The following paper will: (1) summarize a recent survey of geriatric education in the United States schools and colleges of optometry, (2) describe two continuing education projects on gerontology conducted for practicing optometrists, and (3) discuss two recently completed projects involving the training of optometric faculty.
During the 1987 Academy Meeting, a joint Optometric Education/Public Health and Occupational Optometry Symposium was held on The Delivery of Optometric Care in Nontraditional Settings. Papers were presented on prison systems, long-term care facilities, schools for the mental/physically handicapped, home eye care services, migrant work program, and juvenile detention facilities. This paper is an overview of care delivered in nontraditional settings, including important health care and demographic considerations, brief summation of the nontraditional populations presented, the impact on optometric education, and implications for optometric manpower needs.
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Lateral to medial dissection in the "potential space" between the orbicularis oculi muscle and the septum orbitale simplifies the skin-muscle flap lower lid blepharoplasty. The procedure is safe, rapid, and atraumatic.
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Enophthalmos, flattening of the maxilla that may progress to inferior orbital rim and floor defects, eyelid atrophy, and slight relative hypotony occurred in patients with hemifacial atrophy. Less common manifestations included pupillary and iris abnormalities, vertical muscle imbalances, and retinal changes. The prognosis for vision was good. Fluid silicone injection was the major modality in treatment and the results were generally excellent.
Surgical alteration of the platysma muscle improves the results of cervicofacial rhytidoplasty. The operative technique indicated for an individual patient is determined, in part, by the anatomy of the platysma deformity. Many questions regarding the late results of platysma muscle surgery can only be answered by long-term follow-up. This paper presents the results in 75 patients who had platysma muscle flap cervicofacial rhytidoplasty. The 8 most common platysma deformities are discussed. Undesirable results and pitfalls in technique are noted.
A review of the more common and/or more serious complications which may follow rhytidectomy has been presented. The surgeon who performs face lift surgery must be aware of these complications, their incidence, their management, and, in many instances, how they can be prevented, as prevention is the best treatment for postrhytidectomy problems.
More men are undergoing rhytidectomy now. This operation is specifically different in the preoperative planning, the surgical procedure, the postoperative complications, and the final results (compared to rhytidectomy in females). Large hematomas occurred in our male patients more than twice as often as in females.
In 25 random patients undergoing rhytidectomy, we did unilateral subplatysmal-fascial dissections of the superficial musculoaponeurotic system (SMAS) of the face and neck--with redistribution of the tension of this system and fixation by suturing. Late evaluation of these patients by 3 observers showed no detectable difference in the results, as compared to the other side on which the standard technique of skin flap elevation alone was done. Our investigation did not study the usefulness of more extensive dissections of the muscle with complete transection excision of segments of it, or the formation of long muscle flaps.
Although not a frequent occurence, when present a prominent nasal spine contributes to unpleasing septolabial and columella-alar angles which detract from the overall aesthetic quality of the face. It is important to recognize and correct this deformity. In some patients the necessity for spine resection may be subtle. Resection of the nasal spine must be conservative.
Sutures must be chosen on the basis of known biologic properties of the wounds in which they are to be placed, the known interactions of the chosen suture material with tissues of wounds in particular sites, and the intended purpose of the suture material. The following paper concentrates on suture material used to approximate cutaneous wounds, and briefly, the wounds themselves.
The tuberous breast deformity cannot usually be corrected satisfactorily by standard augmentation mammaplasty or mastopexy. The two operative techniques described have been most helpful in dealing with this difficult problem. Anatomic differences in patients may permit or require modification of the techniques to correct a specific deformity. Although our experience to date with these techniques has been limited in number, we have been pleased with the postoperative results.
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Intussusception in the adult is an uncommon condition usually with a chronic history but it may occasionally present as an acute process. The clinical picture is most often that of a large or a small bowel obstruction. When the intussusception begins in the small bowel, a benign causative factor is found most frequently, whereas intussusception of the colon is most often secondary to a malignant lesion. Idiopathic causes occur rarely as compared to the pediatric age group. The treatment of adult intussusception is surgical.
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