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At least 793 records · Page 44Linked to original sources
PubMed1982

Long-term results with the Kaufman prosthesis.

Patients with incontinence after prostatectomy were examined for long-term results following implantation of a Kaufman prosthesis. These appears to be a dichotomy between patients who underwent implantations of the device after radical procedures versus those who had been operated upon for benign disease. Patients undergoing implantation of the prosthesis after an operation for malignant disease experienced a higher rate of complications and a lower over-all continence rate. Also, patients who underwent implantation of the Kaufman prosthesis in conjunction with the Small-Carrion prosthesis showed a 100 per cent failure rate. It appears from the data that the Kaufman prosthesis is not the long sought panacea.

Humans↗
PubMed1981

Evolved improvements in placement of the silicone gel prosthesis for post-prostatectomy incontinence.

During the last 2 1/2 years we have used the silicone gel prosthesis for 8 consecutive patients who were incontinent after prostatectomy. Although the prosthesis had to be replaced in 1 instance a satisfactory result has been obtained by each patient. We believe that with minimal patient selection successful results can be achieved in a large majority of such patients by implementing the evolved improvements in prosthesis placement: 1) use 4 serrated knee staples or George Washington modification to improve fixation, 2) release the urethral bulb from the central perineal tendon for better compression and 3) place the prosthesis higher on the ischiopubic rami. Avoidance of urethral erosion is the single most important aspect of the procedure and intraoperative urethral pressure profile may be helpful in this regard. Guidelines regarding the procedure, prosthesis injection and patient management are discussed briefly.

Gels↗
PubMed1999

Decrease in phantom limb pain associated with prosthesis-induced increased use of an amputation stump in humans.

The experience of phantom limb pain, non-painful phantom limb sensation and telescoping was ascertained by questionnaire in a group of upper extremity amputees wearing a functionally effective Sauerbruch prosthesis which permits extensive use of the affected limb and in a group of patients wearing a cosmetic prosthesis that did little to increase the utilization of the amputation stump. The Sauerbruch prosthesis group exhibited a significant and large decrease in amount of phantom limb pain while the cosmetic prosthesis group showed no change. Neither group experienced a decrease in non-painful phantom limb sensation or telescoping. The amount of phantom limb pain has been found to be highly correlated with the amount of injury-related, afferent-decrease cortical reorganization. It is possible that the increased use of the amputation stump induced by wearing a Sauerbruch prosthesis produced a countervailing use-dependent, afferent-increase type of cortical reorganization that reversed the phantom limb pain. These preliminary results require replication. Their therapeutic implications are discussed.

Adult↗
PubMed1992

Use of an ultrasonic echolocation prosthesis by early visually deprived cats.

The aim of this study was to design an animal model of sensory substitution in the case of blindness. Six kittens were binocularly enucleated; as adults, they were fitted with an ultrasonic echolocation prosthesis. This device provided the animals with auditory signals that coded distance and direction of obstacles. Animals were trained by operant conditioning to use the prosthesis in various behavioral situation. The results showed that visually deprived animals tried to solve the task using natural information and that they only used artificial information provided by the prosthesis when they were unable to succeed with natural cues. Under these conditions, it was asserted that in a jumping test these animals evaluated depth by means of the prosthesis; in a locomotion task in a maze, it was also demonstrated that they could use the prosthesis for avoiding obstacles.

Animals↗
PubMed1998

Penile prosthesis implantation in the treatment of Peyronie's disease.

PURPOSE: This study was undertaken to evaluate the results and complications of penile prosthesis implantation in patients with erectile dysfunction caused by Peyronie's disease. MATERIALS AND METHODS: Men undergoing surgical intervention for erectile dysfunction caused by Peyronie's disease at the University of North Carolina School of Medicine were reviewed. Patients included 30 men aged 29-64 (mean = 49.6) with a duration of Peyronie's disease from 12-72 months (mean = 31.4 months). All men had palpable Peyronie's plague, significant penile curvature and plaque formation. All patients underwent implantation of AMS 700CX penile prostheses from 1993 to 1997. RESULTS: Penile straightening was carried out using modeling in 28 (93%) while plaque incision was necessary in 2 men (7%). All patients had a resultant straight penis with functional penile implant. There were no patients who suffered penile prosthesis infection and no mechanical malfunctions were observed during the follow-up. CONCLUSIONS: Penile prosthesis implantation with modeling is a safe, simple, effective technique for straightening penile curvature in patients undergoing implantation of penile prosthesis for Peyronie's disease. Penile prosthesis implantation is a safe, effective, low morbidity method for restoring potency in men with male erectile dysfunction and Peyronie's disease.

Adult↗
PubMed1976

Effect of a dental prosthesis on speaker-specific characteristics of voice.

Subjects were fitted with an experimental dental appliance which had the effect of lowering and retracting the alveolar-palatal contour. Recordings of subjects speaking without the prosthesis and with the prosthesis at two stages of speech adaptation were analyzed acoustically and by judgmental evaluation for the effect of the appliance in disguising the voice. Individual differences were found in the type and extent of sibilant anf vowel changes produced by wearing the prosthesis. Listeners made more errors on a speaker authentication task involving recordings obtained immediately after the unfamiliar prosthesis was placed in the mouth than on recordings made after a week of accomodation to the appliance, or recordings made a week apart when no prosthesis was worn.

Acoustics↗
PubMed2002

The microsystems based visual prosthesis for optic nerve stimulation.

The microsystems based visual prosthesis (MiViP) visual prosthesis generates visual perceptions well below safety and stimulator saturation limits. These perceptions, called phosphenes, are of reasonably small size and are broadly distributed in the visual field. They can thus be used to convey useful visual information. Psychophysical evaluations are being performed in order to assess the implantee's benefits in the use of the MiViP optic nerve visual prosthesis. In a pattern-recognition task, the performance improved regularly with practice with an increasing score and a decreasing delay to recognition. These observations open the way toward an evaluation of general mobility improvement with the portable system. In conclusion, the results obtained so far still support the potential usefulness of the optic nerve visual prosthesis. A low-resolution artificial vision can be expected from the prosthesis after extensive training.

Electric Stimulation↗
PubMed1982

Treatment of symptomatic gastroesophageal reflux using the Angelchik prosthesis.

During the past 20 months, 28 patients with symptomatic gastroesophageal reflux were treated with the Angelchik anti-reflux prosthesis. The patients ranged in age from 12 to 75 years, with symptoms present from one to 24 years. Vigorous medical management had failed with all patients prior to surgery. Before operation, 28 of 28 patients had upper GI x-rays, 27 of 28 fiberoptic esophagogastroscopy, 26 of 27 esophageal biopsy, eight of 28 Bernstein testing, and 24 of 28 lower esophageal sphincter pressure and motility. Eight patients had strictures requiring preoperative or postoperative dilatation. In four of 28 patients, a Nissen procedure had been previously done. In addition, two patients had metaplastic epithelium, and a single patient a previous Heller myotomy. Twenty-five of the 28 patients are completely asymptomatic eight to 20 months after Angelchik insertion. Fifteen patients had surgery more than one year previously. There are no recurrent hiatal hernias. Endoscopy and biopsy reveal resolution or marked improvement in the esophagitis. Seven patients complained of transient dysphagia lasting up to three months. One patient has persistent "gas bloat" syndrome. There were no technical or perioperative complications. Trouble with the prosthesis occurred in two patients; in one, the prosthesis disrupted and fell into the pelvis, and in the other the prosthesis migrated into the mediastinum. LES pressures preoperatively were 6.17 +/- 0.9 and 16.95 +/- 1.76 mmHg for the 19 patients studied after operation. The limited sample of patients who were studied with preoperative and postoperative acid-reflux tests have all shown improvement in their score. The Angelchik prosthesis in this series has been safe, simple, and reproducible, and can eliminate the symptoms and signs of gastroesophageal reflux.

Adolescent↗
PubMed1998

Ossiculoplasty with an intact stapes: superstructure versus footplate prosthesis placement.

OBJECTIVES/HYPOTHESIS: Many techniques and prostheses are used for ossiculoplasty in the various situations of ossicular chain status that the surgeon may encounter in tympanoplasty procedures. The current study seeks to determine whether any particular technique or prosthesis used by the author demonstrates superior hearing results with fewer failures. STUDY DESIGN: Retrospective review. METHODS: This study retrospectively reviews a consecutive series of cases with intact stapes superstructures, with an intact malleus handle (Austin-Kartush group A) and without (Austin-Kartush group C). The ossiculoplasties were performed with either partial prosthesis techniques from the stapes superstructure to the drum, malleus, or malleus/drum (as is traditionally reported by most authors) or with less frequently advocated total prosthesis techniques from the stapes footplate to the drum, malleus, or malleus/drum. RESULTS/CONCLUSIONS: Of cases for which 1-year postoperative air and bone hearing results were available, group A cases had significantly smaller air-bone gaps than group C cases. There was no difference in mean air-bone gaps between partial and total reconstruction within either group A or C. A few partial and total prosthesis types had low failure rates, good mean air-bone gap hearing results, and tight spread of results to recommend them in group A cases. Total reconstruction had a lower prosthesis failure rate than partial reconstruction in group C cases, although mean air-bone gap hearing results were the same.

Bone Conduction↗
PubMed1980

Small-Carrion penile prosthesis for the management of diabetic impotence.

Of 128 patients who had insertion of a Small-Carrion prosthesis, 36 were diabetic. The insertion of a penile prosthesis in diabetic patients proved to be safe, without increased incidence of infection or rejection of the prosthesis, provided diabetes is under good control before operation. Cystoscopy and cystometrogram are necessary to exclude any possible obstruction or decompensation, thus eliminating potential risk of urinary infection or further decompensation by penile prosthesis. An interval of six weeks after insertion of the prosthesis is needed for resuming sexual activity.

Diabetes Complications↗
PubMed1995

Vertebral body replacement with a ceramic prosthesis for metastatic spinal tumors.

STUDY DESIGN: This study retrospectively analyzed the clinical outcome of vertebral replacement surgery with our unique ceramic prosthesis for spinal metastases. OBJECTIVES: To indicate the results of vertebral replacement surgery with a ceramic prosthesis. SUMMARY OF BACKGROUND DATA: Spinal metastasis often involves the vertebral bodies, of which abnormal fracture causes intractable pain and paresis. For such conditions, laminectomy or irradiation can have no effect because they do not improve spinal stability. Autogenous bone or bone cement are not durable materials, and fatigue fracture of the implanted material occasionally occurs. We developed a simple prosthesis made of alumina ceramic, a bioinert material, to replace the affected vertebrae. There has not been such a large study to assess vertebral replacement surgery with a ceramic prosthesis. METHODS: From 1972 to 1993, 90 ceramic prostheses were used in 84 patients with spinal metastasis, and the average follow-up period was 26.2 months. The primary tumor was thyroid cancer in 13 patients, breast cancer in 12, multiple myeloma in eight, renal cell cancer in eight, gastrointestinal cancer in eight, and lung cancer in eight. The clinical symptoms were assessed before and after surgery, and the maintenance of operative gain was investigated. RESULTS: Pain relief was achieved in 94%, motor function improved in 81%, and ambulation recovered in 64%. There were no serious complications associated with the procedure, and the operative benefit was maintained until the terminal stage in the vast majority of patients. CONCLUSIONS: In selected patients, vertebral replacement using our prosthesis proved to be a useful procedure, effectively managing the severe spinal pain or neurologic deficits associated with vertebral body destruction.

Adolescent↗
PubMed2003

Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level.

STUDY DESIGN: Prospective, concurrently enrolled, multicenter trials of the Bryan Cervical Disc Prosthesis (Medtronic Sofamor Danek, Memphis, TN) were conducted for the treatment of patients with single-level and two-level (bi-level) degenerative disc disease of the cervical spine. OBJECTIVES: The studies were designed to determine whether new functional intervertebral cervical disc prosthesis can provide relief from objective neurologic symptoms and signs, improve the patient's ability to perform activities of daily living, decrease pain, and maintain stability and segmental motion. SUMMARY OF BACKGROUND DATA: The concept of accelerated degeneration of adjacent disc levels as a consequence of increased stress caused by interbody fusion of the cervical spine has been widely postulated. Therefore, reconstruction of a failed intervertebral disc with functional disc prosthesis should offer the same benefits as fusion while simultaneously providing motion and thereby protecting the adjacent level discs from the abnormal stresses associated with fusion. METHODS: Patients with symptomatic cervical radiculopathy and/or myelopathy underwent implantation with the Bryan prosthesis after a standard anterior cervical discectomy. At scheduled follow-up periods, the effectiveness of the device was characterized by evaluating each patient's pain, neurologic function, and radiographically measured range of motion at the implanted level. RESULTS: Clinical success for both studies exceeded the study acceptance criteria of 85%. At 1-year follow-up, the flexion-extension range of motion per level: Discectomy and implantation of the device alleviates neurologic symptoms and signs similar to anterior cervical discectomy and fusion. Radiographic evidence supports maintenance of motion. The procedure is safe and the patients recover quickly. At least 5 years of follow-up will be needed to assess the long-term functionality of the prosthesis and protective influence on adjacent levels.

Adult↗
PubMed2005

Stapedectomy outcomes: titanium versus teflon wire prosthesis.

OBJECTIVE: To compare the effectiveness of two stapes prostheses in hearing improvement of patients undergoing stapes surgery for otosclerosis. STUDY DESIGN: Retrospective chart review. METHODS: Titanium and Teflon wire stapes prostheses were compared with regard to effectiveness in closing the air-bone gap. The charts of 461 stapedectomies performed by one surgeon from 1996 to 2001 were reviewed. Patients who underwent stapedectomy for reasons other than otosclerosis, revision cases, and those with inadequate preoperative or postoperative bone-conduction threshold data were excluded. Small fenestra technique using either laser or drill was used for all patients. Inclusion criteria were met by 218 patients. Patients were then grouped according to type of prosthesis used, and hearing outcomes were compared. Measured outcomes were four frequency air-bone gap closure, pure-tone threshold, and rate of sensorineural hearing loss (SNHL). RESULTS: The study group was comprised of 35 titanium and 183 Teflon wire prostheses. Closure of the air-bone gap to less than 10 dB was achieved in 86% of the patients with Teflon prosthesis compared with 71% of those with titanium prostheses. The groups were equivalent in regard to site of otosclerotic disease as well as technique, laser or drill, used to create the fenestra. Rate of SNHL was low for both groups and not significantly different. CONCLUSIONS: Both prostheses provided comparable results, although the Teflon platinum wire prosthesis was slightly superior. The smaller numbers in the titanium group may confound these results. The design of the titanium prosthesis provides a crimp that is circumferential around the incus, and that prosthesis was selected in cases with a narrow incus. The selection bias may also influence the results seen in this study.

Adolescent↗
PubMed1992

An evaluation of auricular prosthesis using osseointegrated implants.

The purpose of this evaluation is to compare whether retention of auricular prostheses, through utilization of osseointegrated implants rather than by adhesive, provides any improvement in patient acceptance and prosthesis longevity. Forty-seven out of a total of 49 patients having facial prostheses, retained by means of Brånemark fixtures, were surveyed. Ease of retention was noted in 91% of the patients. Satisfaction with the shape of the prosthesis, colour and ease of positioning was 100, 85 and 98% respectively. None of the patients experienced skin irritation under the prosthesis and 94% of them wore their prosthesis daily. Of the 13 patients with previous prosthesis experience, 92% stated improved retention and all of them found ease of positioning and wearing comfort had improved. Durability was better in 62%, unchanged in 23% and worse in 15% of these 13 patients.

Adolescent↗
PubMed1993

Long-term results of vocal rehabilitation after total laryngectomy with the low-resistance, indwelling Provox voice prosthesis system.

A low-resistance indwelling prosthesis for vocal rehabilitation after total laryngectomy, Provox was developed in the Netherlands Cancer Institute 5 years ago. The long-term results in 132 patients using this prosthesis are now reported. The mean and median device life of the prosthesis in the 75 patients in long-term follow-up are 235 and 141 days respectively. Good to fair vocal rehabilitation was achieved in 92% of the patients. Statistical analysis revealed a significant relationship of the device life with the original tumour site (P = 0.0078). Radiotherapy had a borderline (P = 0.0652) negative influence on the device life but not on prosthesis-related complications. Increasing follow-up time has a positive influence on the device life of the prosthesis (P < 0.0001).

Adult↗
PubMedDate not supplied

Suspensory apparatus prosthesis in the horse. Part 1: In vitro mechanical properties.

Mechanical properties of equine suspensory apparatus preparations and three braided synthetic prostheses were evaluated in vitro. Force versus displacement plots and failure modes were recorded from single load-to-failure testing in 18 cadaver limbs before and after replacement of each suspensory apparatus with a prosthesis. Mean load at failure, energy to failure, and stiffness values of polytetrafluoroethylene (PTFE) prostheses were lower than those of the suspensory apparatus and aramid prosthesis. The PTFE prosthesis failed by elongation or rupture of the prosthesis. Mechanical properties of the aramid prosthesis with collar augmentation were not significantly different from the suspensory apparatus. The main site of failure in both aramid prostheses was at the screw fixation to bone.

Animals↗
PubMedDate not supplied

Effect of silicone gel breast prosthesis on electron and photon dose distributions.

The effect of a silicone gel breast prosthesis on the absorbed dose distribution of 9-20 MeV electron beams and 1.25-15 MV photon beams was studied. Compared to water measurements, at depths smaller than the practical range of the electron beams, the central axis depth dose values below the prosthesis were lower for all energies by as much as 3.5%. However, at depths near the practical range, the central axis depth dose values for the prosthesis were greater than that of water by as much as 33%. Since this occurs near the end of the electron range, the resultant difference may not be clinically significant. Results of the effect of breast prosthesis on photon depth dose distributions reveal that no clinically significant perturbation is produced by the breast prosthesis using Co-60, 6- and 15-MV radiations.

Breast Neoplasms↗
PubMed1991

Prosthesis motility with and without intraorbital implants in the anophthalmic socket.

Ocular prosthesis motility was measured and compared in 15 patients with a primary baseball implant after enucleation of an eye, in 11 patients with a secondary baseball implant, in 12 patients with an Allen implant, and in 11 patients without any intraorbital implant. In all patients a noticeable lag of movement of the prosthetic eye was measured: in the extreme directions of gaze the excursions of the prosthesis were far less in comparison with the contralateral normal eye. For normal eye movement round the primary position of gaze, however, the prosthesis motility in the primary baseball and Allen implant group appeared to be sufficient to give a lifelike appearance. The average motility of the prostheses in these two groups did not differ. The motility in the secondary baseball group and in the group without an implant was evidently worse. In the last group the prosthesis motility was most impaired. We conclude that the insertion of an implant, even when inserted some time after the enucleation (a secondary implant), improves the motility of the prosthesis markedly. We recommend the primary baseball implant as the correction of choice after enucleation.

Adolescent↗