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At least 811 records · Page 45Linked to original sources
PubMed1989

Mammography after prosthesis placement for augmentation or reconstructive mammoplasty.

Mammograms of 59 women who underwent placement of a prosthesis for augmentation or reconstructive mammoplasty were retrospectively reviewed. Free silicone was used in five women, retroglandular prostheses in 40, and subpectoral implants in 14. Abnormalities of prosthesis contour were seen only in eight women with retroglandular implants. In another four women, retroglandular prostheses became calcified. In women who received free-silicone injections, coarse calcifications developed in three, and gross nodularity with calcified silicone granulomas developed in one. Five palpable masses developed, three of which were malignant; four masses were in breasts augmented with a retroglandular prosthesis, and they could not be detected with mammography. The mass that developed in a woman with a subpectoral prosthesis could be seen at mammography. The only nonpalpable malignancy detected with mammography was in a breast with a retroglandular prosthesis and contained microcalcifications. The authors conclude that in women with retroglandular prostheses, masses may often be obscured on mammograms by compressed, dense glandular tissue.

Adult↗
PubMed2005

[Duodenal perforation due to an endoscopic biliary prosthesis].

Endoscopic biliary drainage through endoscopic retrograde cholangiopancreatography (ERCP) is a widely accepted therapeutic option in malignant biliary obstructions. However, the procedure is not free of complications. Perforation is one possible complication although it is much less frequent (less than 1%) than pancreatitis (5.4%) or hemorrhage (2%). We present 2 cases of duodenal perforation after placement of a biliary prosthesis through ERCP. Both patients had extensive hilar cholangiocarcinoma. Onset of symptoms of perforation occurred a few hours after placement of the prosthesis and the diagnosis was confirmed by computed tomography and laparotomy. We believe that the mechanism through which perforation occurred was proximal adhesion of the prosthesis to the tumor. This increased the intensity of distal trauma produced by the intraduodenal segment, preventing adaptation of the prosthesis to intestinal peristalsis. A good preventive measure would consist of correctly adjusting the length of the prosthesis in relation to the proximal end of the biliary stenosis.

Aged↗
PubMed1983

Stapedectomy revision of the wire-Gelfoam prosthesis.

Revision procedures in which a vein graft with a Robinson stapes prosthesis was used are reviewed in 100 patients. In all cases a wire-Gelfoam stapes prosthesis had been used initially. The surgical findings were prosthesis malfunction, 48%; eroded incus, 16%; negative findings, 14%; footplate not removed, 11%; oval window fistula, 7%; and incus problems, 4%. Postoperatively, hearing in 70.5% of the patients with conductive hearing loss was within 10 dB and 84.5% within 20 dB. The high success rate is affected by the fact that patients with conductive hearing loss were separated from those with sensorineural hearing loss, a piston prosthesis on tissue was used in the revision surgical procedure, and patients with otosclerosis regrowth did not undergo revision. Surgical directives to minimize hearing loss included use of a tissue seal over the oval window; not reopening the oval window; monitoring the patient for dizziness; performing audiometric tests during surgery; leaving the wire in place in certain cases; and not revising the prosthesis in patients with otosclerosis regrowth.

Adolescent↗
PubMed1990

Cochlear nucleus anatomy related to central electroauditory prosthesis implantation.

The central electroauditory prosthesis is now used to stimulate the cochlear nuclei to obtain auditory perception in patients with bilateral cochlear nerve transection who are undergoing bilateral acoustic tumor removal. In this study, we used fixed cadaver specimens to identify visible landmarks for accurate placement of the central electroauditory prosthesis through a combined suboccipital-translabyrinthine opening. Histologic features of the regions of probable implantation of the central electroauditory prosthesis were also investigated. We found that the following landmarks might have surgical significance: (1) the tenia of the inferior velum of the fourth ventricle, which crosses the surface of the ventral cochlear nucleus and the vestibulocochlear nerve; (2) the angle between the vestibulocochlear and glossopharyngeal nerves; and (3) the foramen of Luschka. It is suggested that an incision be made in the tenia for insertion of the prosthesis into the lateral recess and eventual placement on the ventral cochlear nucleus surface. To study regions of potential stimulation, we injected ink into different sites on the exposed surface of the cochlear nuclei. We then histologically examined neuronal populations adjacent to the sites. We found that a portion of the ventral cochlear nucleus localized within the lateral recess might be the most appropriate location for placement of the central electroauditory prosthesis.

Cochlea↗
PubMedDate not supplied

Replacement of the anterior cruciate ligament using a synthetic prosthesis. An evaluation of graft biology in the dog.

The ACL of 21 adult mongrel dogs was replaced with a knitted dacron velour prosthesis. The biologic fate of these synthetic grafts was then evaluated at various intervals from 1 to 12 months postoperatively using routine histology and a vascular injection (Spalteholz) technique. Following implantation the knitted dacron prosthesis was encapsulated with a vascular synovial tissue in a manner similar to that observed with autogenous patellar tendon grafts. This revascularization process was followed by a proliferation of fibroblasts throughout the extent of the prosthesis. While the grafts appeared to support a fibrous tissue proliferation in and around the design of the prosthesis, this tissue demonstrated only a random orientation of collagen fibers as late as 1 year postoperatively. It would appear, therefore, that although the knitted dacron prosthesis is capable of inducing and supporting tissue encapsulation and ingrowth, it does not allow for the functional orientation of this tissue.

Animals↗
PubMedDate not supplied

Results of conversion total hip prosthesis performed following painful hemiarthroplasty.

Fifteen of 18 cases who underwent conversion total hip prosthesis due to painful hemiarthroplasty, between 1992 and 1997, were investigated retrospectively. The 13 (86.6%) women and two (13.4%) men (mean age, 59 years) were followed up for an average of 32 months. Pre-operative and post-operative Harris hip scores were 36.4 (28 - 42) and 85.9 (69 - 98), respectively. In all cases the femoral component had more than 2 mm radiolucency in Gruen zones I, IV and VII, and five cases had acetabular protrusion; other cases had cartilage erosion. In the last follow-up of conversion total hip prosthesis, there was no radiolucency in either femoral or acetabular components. Comparing our results of conversion total hip prosthesis with primary total hip prosthesis results for femoral neck fractures in the literature we conclude that, in elderly patients with femoral neck fractures, primary total hip prosthesis has better results.

Adult↗
PubMed1990

A new low-resistance, self-retaining prosthesis (Provox) for voice rehabilitation after total laryngectomy.

Prosthetic rehabilitation of voice after total laryngectomy has gained wide acceptance in the last 10 years. Several reliable voice prostheses have been developed and used successfully. Priorities for further development of the methods and instruments for prosthetic voice rehabilitation have led to the design of a low-resistance, self-retaining voice prosthesis (Provox) and an adapted replacement method. The results obtained in 79 patients are described. In vivo airflow resistance ranged from 1.0 to 3.8 kPa (mean = 1.9 kPa). Speech quality was good in 91% of the patients. The self-retaining properties of the prosthesis appeared to be satisfactory. The average device-life was more than 5 months. Replacement of the prosthesis with a new disposable guide wire was done quickly as an outpatient procedure. Maintenance of the prosthesis by the patient was simple. The new low-resistance, self-retaining Provox voice prosthesis and the modified replacement method appeared to further improve the results of prosthetic voice rehabilitation after total laryngectomy.

Adult↗
PubMedDate not supplied

[Questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis].

UNLABELLED: The patient with anophthalmia may present feelings of inferiority and rejection. Knowing his/her needs and expectations contribute to a better technical intervention. PURPOSE: To elaborate a questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis. METHODS: An exploratory research was used to elaborate the questionnaire, by means of a guided interview followed by writing down what was said by the interviewees, who were adult patients of the Bucco-Maxillo-Facial Prosthesis Center of FOSJC - UNESP. The guided interview was made up of 14 items directly related to the future outline of the profile. Each item of the interview resulted in questions of the questionnaire, which was pretested twice before reaching its final version. RESULTS: The patients reported, in the exploratory research, unpleasant feelings with the loss of the eye; relationship shyness; expectations regarding surgery and prosthesis use; a wish to receive explanations and to hold their opinion about the treatment. The questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis is, therefore, made of 43 questions divided into 5 blocks in order to aid the comprehension of the inquired aspects and to facilitate both the computation of data and discussion, and also to improve the selection of questions according to the objective of the researcher or professional. CONCLUSIONS: It was concluded that the questionnaire was viable, can be used in full or by selecting blocks and provide a panorama of the patient's history related to the problem he/she faces, from the loss of the ocular globe to the confection of the prosthesis.

Adult↗
PubMedDate not supplied

The acceptance and satisfaction of Saudi males to vasoactive autoinjection intracavernous therapy, external negative pressure device and penile prosthesis in the treatment of erectile dysfunction.

BACKGROUND: The aim of the study was to determine the acceptance and satisfaction of Saudi impotent male patients to intracavernous vasoactive autoinjection therapy, external negative pressure device and penile prosthesis insertion in the treatment of their impotence. SUBJECTS AND METHODS: The medical records of 210 Saudi patients who presented with erectile dysfunction and were offered intracavernous vasoactive autoinjection therapy, external negative pressure device or penile prostheses for the treatment of their erectile dysfunction were retrospectively analyzed to determine the acceptance and satisfaction of their selected treatment modalities. RESULTS: Intracavernous vasoactive autoinjection therapy was the most acceptable treatment option, followed by negative pressure device, and then insertion of penile prosthesis. About 11.9% of patients refused all treatment options. Only 40% and 12% of patients who were treated with intracavernous vasoactive autoinjection therapy and external negative pressure device, respectively, were satisfied with their treatment modality. After one year of follow-up, insertion of penile prosthesis had the highest satisfaction rate among the treatment modalities, with 92% and 87% of patients being satisfied at 3 and 12 months' follow-up, respectively. CONCLUSION: Intracorporeal vasoactive autoinjection therapy had the highest acceptance rate compared with external negative pressure devices and penile prosthesis, however, it had low satisfaction rate and the dropout rate was high. External negative pressure devices are generally poorly accepted and are rarely satisfactory in our patient population. Penile prosthesis insertion is poorly accepted, however, it has the highest satisfaction rate. Such information will allow patients under treatment for impotence and their treating physicians to make better, educated choices on the mode of treatment.

Journal Article↗
PubMed1984

Complications of the Angelchik antireflux prosthesis.

Various complications have been reported recently for the Angelchik antireflux prosthesis, a silicone-gel prosthesis used in the treatment of gastroesophageal reflux and associated hiatal hernia. We have studied the cases of 11 patients with complications of this prosthesis and have reviewed the literature for others. Complications included 8 erosions of the device into the gastrointestinal tract, 1 migration, 1 improper placement, and 1 case believed to be surgical trauma. These complications represent those typical to reflux surgery and some unique to the Angelchik prosthesis (migration and erosion). The exact frequency is unknown, with the manufacturer estimating migration at 0.81% and erosion at 0.15%. Available data indicate that complications may occur up to several years after implantation, and physicians may not recognize the problems with the prosthesis if they are unaware of the complications.

Adult↗
PubMed1999

Teflon-wire piston or stainless-steel bucket stapes prosthesis: does it make a difference?

The goal of this study was to determine whether postoperative (implantation of a stapes prosthesis) hearing gain and the amount of air-bone gap overclosure are more improved with the Teflon-wire piston or with the stainless-steel bucket prosthesis. We retrospectively reviewed the outcomes of 82 surgeries that had been performed by the primary author; 41 of these patients had received a Fisch Teflon-wire piston, and 41 had received a Bailey-modified Robinson stainless-steel bucket prosthesis. The mean hearing gain for the patients who received the Teflon-wire piston was 23.3 dB after primary stapes surgery and 20.5 dB after revision surgery. Patients who received the stainless-steel bucket prosthesis experienced a mean hearing gain of 20.7 and 20.3 dB, respectively. Following primary stapes surgery, the air-bone gap overclosure was 4.4 dB with the Teflon-wire piston and 5.2 dB with the stainless-steel bucket prosthesis. There was no statistically significant difference in either hearing gain or air-bone gap overclosure between the two prostheses.

Adolescent↗
PubMedDate not supplied

EMG activity of the orbicularis oculi muscle in normal and in individuals indicated to receive eye prosthesis, before and after its placement.

To analyze comparatively through electromyography (EMG) the orbicularis oculi muscle from normal patients and those indicated to receive eye prosthesis (treated patients), it was studied 24 male patients with a mean age of 32.5 years old, who were divided into 2 groups as follows: 12 individuals with absence of the left eyeball and indicated to receive prosthesis (treated); 12 normal individuals (control). The work was performed in 4 different clinical conditions: initial resting; normal opening and closure of the eyelids; forced opening and closure of the eyelids and final resting, before and after placement of eye prosthesis. The exams were made using an Electromyograph K6-I Light Channel and Surface Electrodes. By the results obtained under the work conditions, we can conclude that: the use of eye prosthesis did not interfere in the clinical conditions of opening and closure of the eyelid; the loss of the eyeball increases the EMG activity of the orbicularis oculi muscle; the use of eye prosthesis for a period of 7 days, was not enough to diminish the muscular activity, even its perfect adaptation been evidenced clinically.

Adult↗
PubMed2006

Determining the effectiveness of a vibrotactile balance prosthesis.

We present a quantitative method for characterizing the effectiveness of a balance prosthesis based on tactile vibrators. The balance prosthesis used an array of 12 tactile vibrators (tactors) placed on the anterior and posterior surfaces of the torso to provide body orientation feedback related to the angular position and velocity of anterior-posterior body sway. Body sway was evoked in subjects with normal sensory function and in vestibular loss subjects by rotating the support surface upon which a test subject stood with eyes closed. Tests were performed both with (tactor trials) and without (control trials) the prosthesis activated. Several amplitudes of support surface stimulation were presented with each stimulus following a pseudorandom motion profile. For each stimulus amplitude, a transfer function analysis characterized the amplitude (gain) and timing (phase) of body sway evoked by the support surface stimulus over a frequency range of 0.017 to 2.2 Hz. A comparison of transfer function results from the control trials of normal subjects with results from tactor trials of vestibular loss subjects provided a quantitative measure of the effectiveness of the balance prosthesis in substituting for missing vestibular information. Although this method was illustrated using a specific balance prosthesis, the method is general and could be applied to balance prostheses that utilize other technology.

Adult↗
PubMedDate not supplied

[The Keel Mesh prosthesis: an innovative surgical device for a modern Bassini inguino-crural hernia operation without limits].

Accepting the therapeutic rational underlying laparoscopic and suprapubic laparotomy access, the same therapeutic goal is achieved through direct inguinal access. In this way, using just one prosthesis, inguinal-crural hernias of the Fruchaud pectineus orifice can be treated. The patented three-dimensional pre-cut Keel Mesh prosthesis made of polypropylene monofilament interwoven in a mesh, is tension-free and endowed with plastic memory. It is applied using a slightly modified Lichtenstein technique and is composed of two assembled elements (A and B-C) of different shapes and sizes. From May 2000 to December 2005, the Keel Mesh prosthesis was used in 358 surgical inguino-crural alloplasty operations according to Lichtenstein-De Pascale in 328 patients. Thirty patients were treated with bilateral allo-plasties. Coexistence of a crural hernia was found in 13 male and 4 female patients (5%). At the present time all the patients who are entering into follow-up at different times show perfect compliance of the prosthesis with no relapses. The theoretical and practical considerations regarding the production of the Keel Mesh prosthesis and its easy application suggest it is an extremely valid, rational device for the initial and combined treatment of inguinal and crural hernia.

Female↗
PubMedDate not supplied

[The Fabian prosthesis: our experience in 13 cases].

The spiral intraurethral prosthesis is a device that maintains the urinary tract expedite and overcomes the prostatic obstacle. It is used as an alternative in patients requiring permanent bladder catheters due to prostatic obstruction syndrome that are at high risk for surgery and in those patients that are on the waiting list for surgery. We report the results of a one-year follow-up of 13 patients in whom a prosthesis had been implanted. The spiral prosthesis had to be removed in 6 cases (one due to calcification two months after placement); the remaining 7 patients are still being followed. We briefly analyze the micturition hydrodynamics and the changes of the continence mechanisms and attempt to explain the poor flowmetry results and incontinence observed in these patients with the urological spiral prosthesis. We have recently abandoned the metal prosthesis and now use the so-called "intraureteral catheter" which has become available. However, further experience is warranted in order to determine its results.

Calcinosis↗
PubMed2006

[Semi-joint prosthesis replacement in treatment of malignant tumors around children's knees].

OBJECTIVE: To investigate the effect of the semi-joint prosthesis replacement in treating malignant tumors around the children's knees. METHODS: Five children (aged 8-12 years) with malignant tumors around the proximal end of the tibia underwent the semi-joint prostheses replacement from March 2000 to June 2005. All the children had been diagnosed with osteosarcoma, which was graded as II B by the Enneking staging system. The pathologic changes involved the upper segment of the tibia 9-11 cm in length. Before operation all the patients underwent puncture biopsy and standard chemotherapy. The lesion extent was determined by X-ray, CT and MRI, and then the size of the prosthesis was determined. The length of the prosthesis was 1-2 cm longer than that of the excised bone. After operation the patients were given neoadjuvant chemotherapy for 2 courses and they could walk with the help of a special brace 4 weeks postoperatively. RESULTS: All the 5 patients had a successful semi-joint prosthesis replacement except one patient who had a skin flap necrosis, and the wound healed after a flap grafting. The remaining patients had their wounds healed by first intention. The 12-36 months' follow-up revealed that all the patients had no metastasis or recurrence of the tumor and they were living and well except one patient who died of lung metastasis 8 months after operation. CONCLUSION: The semi-joint prosthesis replacement in the limb salvage surgery for malignant tumors around the children's knees has advantages of avoiding a damage to the normal osteoepiphysis, stabilizing the knee joint, and facilitating elongation of the limb in future. It also creates the condition for total knee replacement in adults.

Arthroplasty, Replacement, Knee↗
PubMed1991

[Implantation of mammary prosthesis through a periareolar incision].

In the past, the mammary prosthesis has always been implanted through anteroaxillary incisions or lateral incision. These incisions are relatively obvious and the scars are prominent. Since October 1988, the authors have used the periareolar incision to perform mammary prosthesis implantation in 15 cases, 28 breasts. The skin and subcutaneous tissue are incised along the edge of the areola and the tissue are split along the direction of mammary ducts and that of the musculus pectoralis major. Then a cavity is made underneath the pectoralis major muscle and a prosthesis is implanted. According to the patient's demand regarding the size of breast, the volume may be increased or lessened. In this operation the incision is small, the scar is not obvious, and the dissection is easy. The method is used only when an inflatable breast silicon prosthesis is used. During the operation due attention should be paid to the size and position of the prosthesis so that two breasts are symmetrical.

Adult↗
PubMedDate not supplied

[Use of the Wiruthan prosthesis in uretero-cutaneostomy].

Ureterocutaneostomy (UCS) is a urinary diversion (UD) which is current little used, since, in addition to its very invalidating character, especially from a socio-psychological point of view, it is accompanied by complications such as ureteral stenosis, infections and parenchymal injury. Some of these complications may be partly related to the type of prosthesis used. From January 1987 prosthesis in Wiruthan polyurethane, an inert material with excellent biocompatibility features, were used in 20 patients who had to undergo UCS. The use of these long-lasting prosthesis was easy, well tolerated and enabled the patients to achieve a better quality of life. The prosthesis required moderate maintenance and reduced the complications which are often found in UCS. This positive experience prompts the Authors to recommend the use of these prosthesis in patients with UD.

Aged↗