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PubMed2002

Experience with vertical partial laryngectomy with special reference to laryngeal reconstruction with cervical fascia.

In this paper we report our experience of vertical partial laryngectomy using the superficial cervical fascia; we describe the technique and present the functional and oncological results of this method of treatment. A total of 42 patients with squamous cell carcinoma of the true vocal folds, in stage T(1) (n = 28) or T(2) (n = 14), were treated in our department using vertical partial laryngectomy during the decade 1987-1997. Nine patients had post-operative radiotherapy. The shortest follow-up time was three years. There were six recurrences in all, four in the larynx and two in the neck. All four of the laryngeal recurrences were treated with total laryngectomy and are doing well. Both the patients with neck metastases, who were treated with neck dissection, died. Permanent tracheotomy was necessary in one patient. There were no problems with aspiration. The recurrence rate was 14 per cent, the three-year survival index was 95.2 per cent and the three-year larynx preservation index was 90 per cent. According to our experience, vertical partial laryngectomy, using the method we describe, has a good functional and oncological result for stage T(1) and T(2) tumours.

Adult↗
PubMed1989

Results of tympanoplasty for congenital aural atresia and stenosis, with special reference to fascia and homograft as the graft material of the tympanic membrane.

The surgical management of congenital aural atresia is a challenging, complex procedure, and the risks are great. The otologic surgeon is responsible for keeping a patent external auditory canal and for achieving satisfactory hearing. The present report studied hearing changes that occurred after tympanoplasty and the long-term results of tympanoplasty in 12 cases of congenital aural atresia or stenosis. Patients were followed for more than 2 years after surgery. In four ears, an allograft of the tympanic membrane with an attached malleus was used, with a good graft take and hearing results. An autograft of temporal fascia was used in eight ears. Hearing acuity decreased in six of the eight ears and was maintained in two ears. Three primary surgery patients required revision surgery for postoperative restenosis of the external auditory canal. Some comments have been made with regard to this problem. Emphasis is also placed on the selection of patients for surgery using a thorough audiologic and roentgenologic evaluation.

Adolescent↗
PubMed2000

Scapulothoracic stabilisation for winging of the scapula using strips of autogenous fascia lata.

We have used a modified technique in five patients to correct winging of the scapula caused by injury to the brachial plexus or the long thoracic nerve during transaxillary resection of the first rib. The procedure stabilises the scapulothoracic articulation by using strips of autogenous fascia lata wrapped around the 4th, 6th and 7th ribs at least two, and preferably three, times. The mean age of the patients at the time of operation was 38 years (26 to 47) and the mean follow-up six years and four months (three years and three months to 11 years). Satisfactory stability was achieved in all patients with considerable improvement in shoulder function. There were no complications.

Adult↗
PubMed1988

Transantral repair of cerebrospinal fluid fistulas using bone chips, Tisseel, fascia and plaster of Paris.

Cerebrospinal rhinorrhea is a potentially serious symptom due to the risk of an ascending infection, which may produce a fulminant meningitis. Plaster of Paris has been used to obliterate the sphenoidal sinus and posterior ethmoids in five patients with cerebrospinal rhinorrhea. The fistulas were identified by computed cisternography and repaired by a transantral approach using a microsurgical technique, and bone chips, Tisseel and fascia to seal the fistulas. There have been no postoperative problems or leakage in the three patients with fistulas to the sphenoidal sinus. The cerebrospinal rhinorrhea recurred four and six months after operation in the two patients with fistulas to the posterior ethmoids probably due to surgical, technical problems in one patient and to less support by the plaster of Paris, when the fistulas end in this region. However, the described surgical technique seems to be a good alternative for fistulas to the sphenoidal sinus and should be included in our surgical armamentarium.

Adult↗
PubMedDate not supplied

The surgical correction of paralytic strabismus using fascia lata.

OBJECTIVE: To present the results of a new technique designed to restore and maintain alignment, exclusively in the primary position, in patients with paralytic strabismus. METHODS: In five patients (seven eyes, total) with exotropia secondary to third-nerve palsy, we fixated the globe with a strip of fascia lata sutured onto both the medial aspect of the eye and the nasal bone periosteum. We characterized the ocular deviation in the primary position with prism diopters the day before the operation, during the initial 24-hour period, and at subsequent monthly postoperative evaluations. We documented all evaluations with photographs. RESULTS: In all patients, the ocular position improved with the surgery. No further change of the ocular position was noted during the follow-up period, which ranged from 15 to 35 months (mean follow up 22.5 months). All the patients tolerated the collagenous tissue without complications. CONCLUSIONS: This procedure can be a useful addition to the current surgical techniques for management of strabismus secondary to third-nerve paralysis.

Adolescent↗
PubMed1991

Skin and superficial fascia of the foot.

The authors provide a brief review of the structure of the skin in general and the specializations of the plantar skin and superficial fascia. This review is intended to provide a basis from which the reader can interpret any relevant data in other papers on anatomy and to direct the reader to a variety of more detailed references.

Fascia↗
PubMed1996

Role of the plantar fascia in digital stabilization. A case report.

The plantar aponeurosis is a ligamentous structure that extends from the calcaneus to the proximal phalanges. Under tension, it functions to support the longitudinal arch, supinate the rearfoot, and stabilize the digits against the ground. The anatomy and biomechanics of the plantar fascia and plantar aponeurosis, particularly their role in digital stabilization, are reviewed. A case is presented showing a patient who developed hammer toes as a postoperative complication after having a portion of the plantar aponeurosis removed.

Fascia↗
PubMed2002

Extensor hallucis longus tendon rupture repair using a fascia lata allograft.

The authors present a case of a traumatic extensor hallucis longus tendon rupture sustained 2 days after hallux valgus and hammer toe correction. The ruptured tendon, separated by a 6-cm defect, was repaired using a fascia lata allograft. This case demonstrates a serious complication of a commonly performed procedure and a salvage technique useful for dealing with large tendon defects.

Adult↗
PubMed1998

[The use of the temporal fascia pedicle flap for the reconstruction of the posterior wall in the external auditory meatus and osteovit obliteration of the mastoid process in the surgical treatment of chronic cholesteatoma in otitis media].

The authors present the results of the treatment of 34 patients with chronic cholesteatomatous otitis media in whom the posterior wall of the external auditory meatus was reconstructed by remodelling the pedicel flap of the temporal fascia and by obliterating the mastoid process with Osteovit. The results of the operation were estimated with reference to the time of the postoperative cavity getting dry and compared with the control group of individuals in whom radical conservative operation was performed. The results proved that the epithelialization time was distinctly shorter and neither granulation nor otorrhea appeared during 24 months' observation.

Adolescent↗
PubMed1998

[Suspending of blepharoptosis on temporalis fascia slings: our own experience].

There are many procedures providing treatment of ptosis. In cases with palpebrae levator palsy, procedures involving mechanical suspension of palpebrae are used. Artificial and natural materials are used to suspend the lid. We describe surgical treatment of blepharoptosis using autogenous temporalis fascia sling. The sling is attached to the tarsus and spreads to the frontalis muscle. We have used this procedure in 12 cases. Full effect of functional elevation of palpebrae was achieved in 14 to 30 days after procedure. We did not encounter any significant complications due to this material. These operative modifications make this procedure more closely parallel to the normal eyelid dynamics and provide consistently good results for this difficult problem.

Adolescent↗
PubMed1975

Malignant tracheoesophageal fistula secondary to Hodgkin's disease. Successful surgical treatment with free fascia-muscle graft and left colon bypass.

A case of malignant tracheoesophageal fistula due to Hodgkin's disease at the mediastinum and mid-third of the esophagus is reported. The fistula developed after x-ray therapy (2,000 rads) to the medistinum. In another hospital, she had undergone two unsuccessful attempts to close the fistula surgically with muscle flap grafts, following tracheostomy and feeding gastrostomy. The third operation, performed successfully 2 months later at The Roosevelt Hospital, included division of the esophagus above the fistula with cervical esophagostomy. A free muscle graft was used to close the fistula in the trachea. One month later, subcutaneous antiperistaltic left colon bypass was performed in one stage to connect the cervical esophagus with the lower stomach. At the same time, distal closure of esophagus at the cardia, pyloroplasty, and splenectomy were done. These operations allowed that time, recurrence of the fistula necessitated a fourth operative repair. This time, a 2 inch square piece of fascia and its underlying muscle from the gluteus medius were used to reinforce the closure. The fistula remains closed to date.

Adult↗
PubMed2000

[Evaluation of derma and fat combined pedicled superficial temporal fascia flap for reconstruction of facial depression].

OBJECTIVE: To evaluate the curative effect of derma and fat combined pedicled superficial temporal fascia flap for reconstruction of facial depression. METHOD: Postoperative follow-up and comparative study were performed. 10 cases of facial depression deformities were involved, in which 5 cases were hemifacial atrophy, and 5 cases were branchial arch maldevelopment. RESULTS: Postoperative follow-up for 1-3 years showed that the method produced better results in branchial arch depression than in hemifacial atrophy. The combined tissue used in plomb of branchial arch maldevelopment had a low ratio of anaphase absorption, maintaining a satisfactory long-term full contour. In plomb of hemifacial atrophy, the anaphase absorption ratio of the was combined tissue approximately 20%-40%. CONCLUSIONS: The noxa of depression ought to be noticed when this method is used in reconstruction of facial depression. The exorbitant plomb is inadvisable for facial depression of branchial arch maldevelopment. However, in facial depression of hemifacial atrophy, in considering anaphases absorption, the suitable exorbitant plomb is reasonable for better future results.

Adolescent↗
PubMed1975

The fascia of the distal phalanx.

The anatomy of the distal phalanx of the human finger was studied in preserved and fresh specimens and the fascia was related to associated structures as a mechanism for prehension. Particular attention was directed to the lateral interosseous ligaments of the distal phalanx and their possible function during gripping with the digital pulp.

Adipose Tissue↗
PubMedDate not supplied

Fascia lata autograft for orbital floor reconstruction.

Enophthalmos and diplopia are two major complications that result from a downward displacement of the eyeball. A case in which a fascia lata autograft was used to prevent these complications is presented. When covered by a flap with rich blood supply, this autograft can be used as a good substitute for alloplastic materials.

Fascia Lata↗
PubMedDate not supplied

Anterior abdominal wall reconstruction with fascia lata.

Anterior abdominal wall is a complex fasciomuscular structure, defects of which may arise as a result of infection, trauma, malignancy and herniation. Different techniques have been devised to repair these defects with varying result, availability and cost implications. In the communication, the use of fascia lata for repair of major anterior abdominal wall defect in five patients is reported. The result suggests that this is a useful technique that is associated with satisfactory outcome and minimal morbidity.

Abdominal Muscles↗
PubMed1975

[Histological study of otological homografts (incus, cartilage and fascia) (author's transl)].

To summarise our morphological findings of this study the following conclusions are drawn: In bone grafts growth of vital cells originating from the Haversian canals is clearly demonstrated. The growth of connective tissue in the Haversian system is understandable on general principles of pathology. The morphology of the change of osteocytes from fibrocytes through osteoblasts is photographically clearly shown and is in keeping with the findings of Steinbach and of Kerr and Smyth. New bone formation was detected at earliest nine months after implantation. Our investigations do not confirm whether this new bone formation occurs persistently in all cases or to what extent the original homograft material, preserves in cialit solution, takes part in this process. A similar mechanism of tissue regrowth should be accepted in homograft cartilage. We have studied two cases, one after 6 months and the other after 5 years following implant. The three fascial grafts examined compare with earlier publications, with oedema, slight inflammation and little shrinkage occurring. The suitability for grafting of homograft incus, cartilage and fascia we believe to have been demonstrated.

Adult↗