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PubMedDate not supplied

CT features of perirectal fascia thickening after transurethral resection of prostatic adenoma.

Thickening of the perirectal fascia (PRF) has been described as a CT sign of local extension of pelvic cancers. It has been observed also after radiation therapy and various pelvic surgical procedures. To demonstrate prospectively its nonspecificity, we systematically looked for such thickening before and after consecutive uneventful transurethral prostatic resections in 17 patients presenting with benign adenomas and in one patient with an unexpected prostatic carcinoma. In six patients (33%) obvious PRF thickening appeared on postoperative CT. Thus, this cause of fascial thickening must be considered when evaluating pelvic cancers.

Fascia↗
PubMed2004

Intralingual injection of particulate fascia for tongue paralysis.

This article reports for the first time in the medical literature an intralingual injection for the treatment of tongue paralysis. Hemiatrophy of the tongue produces a disabling problem of dysarthria and dysphagia because of discoordinated tongue movement, poor contact pressure, and areas of dead space. If a reversible neurologic etiology is not found, the patient may benefit from speech therapy, although recovery is often incomplete. In this case report, repeat injections of 80 mg of 0.5 mm preserved particulate fascia (Fascian) into the paralyzed half-tongue improved lingual symmetry and the patient's overall control of the tongue.

Aged↗
PubMed1980

Primary closure of trochanteric decubitus ulcers: the bipedicle tensor fascia lata musculocutaneous flap.

A surgical procedure is described for the definitive treatment of trochanteric decubitus ulcers. It combines the advantages of the bipedicle skin flap and the musculocutaneous flap; that is, a large area of skin is provided with a thick protective padding consisting of fat, fascia, and muscle richly vascularized by the musculocutaneous perforating circulation. The disadvantages of either flap alone (i.e., dependence on dermal blood supply and skin grafting of the donor bed) are avoided. In patients who are traditionally the most difficult nursing problems, this one-stage reconstructive procedure results in shorter operating room time, easier postoperative care, shorter hospital convalescence, and an enduring protection against recurrent trochanteric pressure problems.

Fascia↗
PubMed1981

The tensor fascia lata: variations on a theme.

Using more of the true musculocutaneous (or proximal) portion of the tensor fascia lata enables the surgeon to augment its bulk, include bone in the flap, close the donor site primarily, and use the flap even if the distal fascial compartment has been damaged. Alternative designs, inclusion of bone in the flap, and tetracycline bone labeling are discussed.

Fascia Lata↗
PubMed1984

Temporoparietal free fascia grafts in rhinoplasty.

The temporoparietal fascial graft provides adequate coverage, contour, and bulk on the cartilage dorsum of the nose, as well as an inconspicuous donor site. In my opinion, this technique not only prevents the occurrence of noticeable sharp edges of the cartilage graft, but also adds to the smooth contour of the reconstructed nasal dorsum. The improved results either in primary and secondary rhinoplasty would seem to justify this technique. Some variations in fascia grafts are presented with clinical examples.

Adult↗
PubMed1988

Malar augmentation using autogenous composite conchal cartilage and temporalis fascia.

Prominent malar regions are considered by many in Western society to be a mark of beauty. The increased awareness of this important aesthetic feature has made correction of the poorly defined cheekbone one of the goals of aesthetic surgery of the face. Procedures incorporating alloplastic materials have been described. However, malar implants of this type have not been universally accepted. Silicone gel-filled, silicone rubber, and Proplast implants have enjoyed popularity in facial augmentation. Each of these materials shows low complication rates, but problems related to use are (1) the inevitability of formation of a tissue capsule, which, although responsible for implant stabilization, also may cause deformation of silicone implants, and (2) bacterial contamination at the tissue-implant interface. We propose a new technique of malar augmentation through the use of composite autogenous conchal cartilage grafts and temporalis fascia grafts. A case report and illustrations are presented, including a description of this technique. It is postulated that the use of autogenous materials in malar augmentation can give acceptable results and obviate the inherent risks associated with the use of alloplastic materials.

Cartilage↗
PubMed1996

Fascia lata suspension of malpositioned ears.

A new technique for the correction of malpositioned ears in congenital or acquired disorders is described. The use of a fascia lata strip makes a rigid fixation of the ear to the pericranium possible without total fixation of the ear in all directions. The configuration of the auricle is not altered, and the scars are inconspicuous.

Adolescent↗
PubMed1998

Preexpansion of the tensor fasciae latae for free-flap transfer.

Preexpansion has become an established technique to prefabricate elective free flap transfers. We report the use of the tensor fasciae latae flap as a donor site in two cases for reconstruction of a burn scar neck contracture and an unstable contralateral below-knee amputation stump, of which other donor sites were ruled out either by the patients' condition or by choice. Implantation and transfer were straightforward and the donor sites of very large flaps were minimized by preexpansion. The preexpanded muscle fasciocutaneous flaps were transplanted with microsurgical anastomoses of the vessels. Apart from a small area of necrosis at the distal tip of the flap developing on the sixth postoperative day, which we excised in a second operation, there were no major complications. The advantages of the combination of preexpansion and free flap transfer as well as the unique anatomical and functional qualities of this musculocutaneous unit are emphasized.

Adult↗
PubMed1998

Reconstruction of a large abdominal wall defect using combined free tensor fasciae latae musculocutaneous flap and anterolateral thigh flap.

A large abdominal wall defect was reconstructed with the use of a flap combining the tensor fasciae latae musculocutaneous flap and the anterolateral thigh flap in four individuals who had undergone extensive abdominal wall resection because of cancer. The flap was harvested as a single combined composite flap and was transferred to the recipient site by means of microvascular surgery. Morbidity was minimal and the outcome was satisfactory in all instances.

Abdominal Muscles↗
PubMedDate not supplied

The long-term analgesic efficacy of a single-shot fascia iliaca compartment block in burn patients undergoing skin-grafting procedures.

In a previous study, we assessed the efficacy of a continuous fascia iliaca compartment block (FICB) in reducing the pain at thigh autograft skin donor sites. However, a continuous local anesthetic infusion may cause toxicity or infection. In this prospective, randomized double-blind study, we compared the analgesic efficacy of FICB when given as a single shot vs continuous infusion during the 72-hour postoperative period up to the first dressing change (1dc). After ethical committee approval and informed consent, 81 adults (with 1% to 20% total burn surface area) who were scheduled for split-skin graft harvest procedures of the thigh underwent the FICB procedure before general or spinal anesthesia. Via FICB, patients received a bolus of 40 ml followed by 10 ml/hr consisting of either ropivacaine 0.2% for bolus and infusion (continuous, n = 27), or ropivacaine 0.2% for bolus and saline for infusion (single-shot, n = 27), or saline for both bolus and infusion (control, n = 27) until 1dc. Postoperative analgesia consisted of morphine via a patient-controlled analgesia device. We compared cumulative morphine consumption, static and dynamic pain scores, and side effects related to morphine or ropivacaine during the 72 hours up to 1dc. A single block had the same morphine sparing-effect as the continuous technique. Both techniques were equally effective in diminishing dynamic pain and reducing the side effects normally associated with morphine. However, patients receiving a single block experienced less residual paresia and were more satisfied with their pain-relief treatment than those who received a continuous infusion. A single-shot FICB is an easy, inexpensive, and efficient method for diminishing pain at thigh donor sites during a 72-hour postoperative period and has limited side effects and no residual paresia.

Adolescent↗
PubMed2005

Autologous transplantation of fascia into the vocal fold: long-term result of type-1 transplantation and the future.

OBJECTIVES: Since 1997, we have performed the autologous transplantation of fascia into the vocal fold (ATFV) procedure on cases of sulcus vocalis. In what follows, we report the long-term results of our new surgical approach and discuss the role of these transplantations. We also review and report some complications that can be caused by ATFV. Finally, we discuss the ATFV technique as a contribution to the phonosurgery of the future. STUDY DESIGN: Prospective study. METHODS: We were able to obtain long-term results from 10 volunteer cases (2 female and 8 male, age: 15-71, mean 46.5 years old) who could be followed up for at least 3 years after transplantation. All were cases of pathologic sulcus vocalis.We measured maximum phonation time (MPT) and carried out pre- and postsurgical clinical observation and laryngeal stroboscopy in all cases. These measurements and observations were made before the ATFV and at 6 months, 1 year, 2 years, and 3 years after surgery. RESULTS: In stroboscopic observation 1 year after the ATFV, satisfactory glottal closure and excellent mucosal wave were observed for all cases, and there was no case with hyperadduction of the false vocal folds. MPT measures remained at an improved level 2 years and 3 years after the transplantations. Paired-sample t tests showed that the improvement relative to preATFV levels was significant for all postsurgical measurements up to 3 years. CONCLUSIONS: We conclude that ATFV is a successful surgical procedure for sulcus vocalis and scarred vocal folds. Other phonosurgical clinical applications may also be envisioned.

Adolescent↗
PubMed2006

Tear of plantar fascia and tibiocalcaneal ligament with positive F-18 FDG PET findings.

Although PET/CT imaging provides the most comprehensive evaluation of cancer, coexisting hypermetabolic benign processes may interfere with the staging of aggressive malignancy such as melanoma and extranodal non-Hodgkin lymphoma. Acute and subacute skeletal injuries have been reported as false-positive PET findings. The authors present additional mimickers of high metabolic malignancy with a case of stage III recurrent melanoma featuring F-18 FDG accumulation at partially torn medial plantar fascia and tibiocalcaneal ligament of the left foot.

Ankle Injuries↗
PubMed2005

The "duck" modification of the tensor fascia lata flap.

Various common locations of pressure sores require specific considerations. The most commonly used flap for the treatment of trochanteric ulcers is the tensor fascia lata (TFL) flap. According to our experience with the original flap, excessive tension and eventual suture separation at the confluence of the donor site flaps and the TFL flap is the most common problem. The purpose of this article is to present a new design for the TFL flap for the coverage of trochanteric pressure sores. An anterior triangular extension is designed exactly at a point where the flaps that will cover the donor site unite after transposition. The desepithelialized proximal part of the flap is folded into the pouch and sutured. The duck flap was applied to 31 trochanteric pressure sores in 27 patients with no major complications. This modification has many advantages: (1) the flap is reliable and easily designed, (2) formation of dead space and cone-shaped dog-ear deformity due to rotation is prevented, (3) better esthetic results are achieved, (4) suture separation is prevented via a tension-free closure, (5) the desepithelialized part produces tight attachment of the flap to the recipient bed, (6) as no muscle tissue is included, the flap is more resistant to pressure.

Adult↗
PubMed2006

The relationship of capsulopalpebral fascia with orbital septum of the lower eyelid: an anatomic study under magnification.

The aim of this study is to elucidate each insertion of the capsulopalpebral fascia (CPF) and orbital septum (OS) in the lower eyelid. Fifteen eyelid specimens were obtained from 15 Korean male adult cadavers for the study. Three parasagittal sections were made apart at medial limbus, midpupillary line and lateral limbus. The specimens were cut in 10-mum sections, stained with Masson-trichrome and observed under light microscopy. The head of the CPF split open superiorly and inferiorly wrapping around the inferior oblique muscle and met anteriorly. CPF inserted to the inferior border of the tarsus, merging the anterior border of the inferior tarsal muscles. OS blended with CPF most closely at 3.7-5.4 mm beneath the lower tarsal border: and differently at 3.7 +/- 0.7 mm on the medial limbus line, 4.3 +/- 0.8 mm on the midpupillary line and 5.4 +/- 1.0 mm on the lateral limbus line. The blending level is closer to the tarsus at the medial side than the lateral side. The closest distance between the lower tarsal border and the first identifiable smooth muscle nuclei of the inferior tarsal muscle was 2.1-2.7 mm, and differently 2.7 +/- 0.7 mm on the medial limbus line, 2.7 +/- 0.7 mm on the midpupillary line and 2.1 +/- 0.9 mm on the lateral limbus line. Precise anatomical understanding of OS and CPF may be conducive to the lower eyelid surgery.

Aged↗
PubMed2004

Successful treatment of head and neck cancer involving the prevertebral fascia.

Chemotherapy with radiation has become more popular than radiotherapy alone for patients with locally advanced head and neck cancer because of the successful results associated with it. We report the case of a 67-year-old man with hypopharyngeal cancer invading the prevertebral fascia who became free of disease after chemoradiation. This uncommon, positive observation supports the impression that combined therapy is efficacious in some patients with advanced stage carcinoma of the upper aerodigestive tract.

Aged↗
PubMedDate not supplied

Ambulation after transfer of adductors, external oblique, and tensor fascia lata in myelomeningocele.

Forty-seven patients with myelomeningocele underwent triple (adductor, external oblique, and tensor fascia lata) transfers or double (adductor and external oblique) transfers and were retrospectively reviewed. Six patients lost significant neurologic function during the 4-years 6-month follow-up. Thirty-seven of the remaining 41 patients had improved gait pattern. Seventeen required less bracing after the muscle transfers. The need for assistive devices decreased in 21 patients. Twenty-seven were able to ambulate independently postoperatively as compared with seven preoperatively. The muscle transfers are indicated in midlumbar and lowlumbar spina bifida patients to improve hip stability, control, balance, and gait pattern.

Adolescent↗
PubMed1998

The tensor fasciae latae myocutaneous flap closure of major chest and abdominal wall defects.

BACKGROUND: The usual methods of closure of major chest and abdominal wall defects have significant disadvantages. Skin grafts provide no structural support and result in incisional hernias. Synthetic mesh requires skin cover and is prone to infection and wound breakdown. The tensor fasciae latae (TFL) myocutaneous flap offers skin cover and a semi-rigid fascial layer. We document our unit's experience in pedicled and free TFL flaps. METHODS: The TFL flap closure of trunk defects was undertaken in 10 patients between August 1989 and April 1997. All cases were not amenable to primary closure and repair with synthetic mesh or skin grafts. RESULTS: The defect was satisfactorily repaired in all cases without subsequent herniation. The closure techniques using a pedicled TFL flap and a TFL flap for a free-tissue transfer are described. CONCLUSIONS: We conclude that the TFL flap is the method of choice for repairs of major truncal defects.

Abdominal Muscles↗