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At least 1,027 records · Page 57Linked to original sources
PubMed2003

A new surgical approach to extensive tumors in the pterygomaxillary fossa and the skull base.

OBJECTIVE: The article describes a new surgical approach to extensive tumors in the pterygomaxillary fossa and the middle skull base. METHODS: The first incision divides the upper lip in the midline, passes under the nasal pyramid, and extends laterally, reaching the level of the temporamandibular joint, at which point it exits to meet the vertical coronal/preauricular incision. An incision is then made along the maxillary buccogingival fold on the involved side, running from the midline to the retromolar area. Another incision is made along the mandibular buccogingival fold on the involved side, running from canine to retromolar area. The cheek flap is reflected inferiorly to the level of the angle of mandible after the elevation of the maxillary and mandibular periosteum and the messeteric fascia in a downward fashion. The frontotemporal scalp is reflected toward the midline after completion of the coronal and transtemporal incision and an appropriate undermining. The craniofacial skeleton is exposed from the midline. After osteotomies of the orbitomaxillary skeleton and a horizontal subperiosteal osteotomy at the angle of the mandible are completed, a frontotemporal craniotomy is performed, and the foramina spinosum, ovale, and rotundum, as well as the superior orbital fissure, are identified. The tumor is exposed in the surgical field; after the tumor is resected, the orbitomaxillary skeleton and the mandibular namus, removed during the approach phase, are replaced and affixed by miniplate. The external soft tissues, including the skin, are then reapproximated along the preoperative markings. RESULTS: The surgical field obtained at the skull base extends from the contralateral eustachian tube to ipsilateral geniculate ganglion. It includes the nasopharynx, clivus, sphenoid, cavernous sinus, and the entire infratemporal fossa, as well as superior orbital fissure and the pterygopalatine fossa. This approach was used in 5 patients. All patients healed per primum. CONCLUSION: This technique is especially useful for excising tumors in the nasopharynx, clivus, superior orbital fissure-cavernous sinus, and infratemporal and pterygopalatine fossa.

Cavernous Sinus↗
PubMed1978

Blepharophimosis with associated cup-lop ears.

Blepharophimosis is a rare congenital triad consisting of epicanthus inversus, blepharoptosis, and a wider than normal intercanthal distance. Attention has recently been drawn to abnormalities of the eyebrow and the poorly developed nasal bridge. I record 9 cases of blepharophimosis associated with cup-lop ears seen over the last 15 years. These include a father and his 4 children.

Adolescent↗
PubMed1987

Lower eyelid examination following blepharoplasty in the monkey.

To determine the validity and reliability of the physical examination in evaluating abnormalities of the lower eyelid following blepharoplasty, a model using monkeys was developed. One plastic surgeon performed a variety of blepharoplasties, including extensive resection of lower lid skin and/or muscle, and/or the creation of scarring in the orbital septum. Three months postoperatively, a second plastic surgeon and an ophthalmologist examined these monkeys' lower eyelids. Although there was substantial agreement between the observers as to the degree of scleral show and which eye was "worse" in each monkey, the examiners were correct in just 7 of 24 attempts to identify the exact operative procedure that had been performed. This study demonstrates that it is difficult to identify the cause of abnormalities in appearance and position of the lower lid after blepharoplasty. Orbital septal scarring can cause the same degree of scleral show as excessive skin resection. Muscle resection contributed little to lower lid position.

Animals↗
PubMed1988

Upper lid musculocutaneous flap.

The use of a musculocutaneous flap from the upper lid for reconstruction in the orbital region and neighboring areas is described. The anatomical basis is considered. Because of its blood supply, the flap can be raised on its lateral or medical pedicle. When based on its lateral pedicle, innervation can be maintained by raising an innervated musculocutaneous flap, which can restore proper lower lid position and tonus. Twenty-two patients were operated on with this technique to fill defects of the lower and upper lid as well as of the lateral nasal wall. All flaps survived, and only minor deformities of the donor site were seen when the eyebrows were included in the flap.

Adult↗
PubMed1987

Fire in surgery.

Explore the source record for details and available documents.

Cautery↗
PubMed1989

Unusual complication of strabismus and lid surgery.

A patient with longstanding dysthyroid eye disease developed a broad adhesion between the globe and the upper eyelid following simultaneous surgery to recess the levator palpebrae superioris and lateral rectus muscles. This unusual complication may have developed as a consequence of failure to suture the conjuctiva of the upper fornix to the tarsus and also due to the prolonged static contact between the resulting adjacent raw areas due to postoperative eyelid traction and pressure dressings. Periods of such contact may have been further prolonged by the action of diazepam, which reduces the peak velocity of saccadic eye movements and suppresses rapid eye movement of sleep. Eyelid surgery should be performed as a separate procedure, under local anesthetic after healing of areas bare of conjunctiva from strabismus surgery utilizing the adjustable suture technique.

Conjunctiva↗
PubMed2001

Use of heat-malleable thermoplastic splints in eyelid skin grafting.

PURPOSE: To report on the usage of a thermoplastic material in eyelid reconstruction. METHODS: Retrospective single-surgeon case review. RESULTS: Thirty-eight full-thickness skin grafts in 37 patients are reported. No major complications were encountered. All outcomes with the use of this technique yielded satisfactory results. CONCLUSIONS: The use of thermoplastic materials in eyelid reconstruction appears to achieve results equal to those seen with traditional materials. This technique in eyelid surgery may save operative time and be less expensive than traditional methods.

Aged↗
PubMed2002

Medial tarsal suspension: a method of elevating the medial lower eyelid.

PURPOSE: When attempting to elevate the lower eyelid for any reason, medial elevation is the most difficult to attain. Medial canthal tendon tightening creates mostly horizontal tension and contributes little vertical vector. We present a technique for applying a lifting force to the medial end of the eyelid: medial tarsal suspension. METHODS: The technique to suspend the medial lower eyelid tarsal plate to the superior orbital rim periosteum is described. The procedure, medial tarsal suspension (MTS), was performed on 38 lower lids of 24 patients. Adjunctive procedures, most commonly lateral canthal sling, were performed on 66% of the lids at the time of the initial medial tarsal suspension. The patients ranged in age from 29 years to 84 years. All had medial lower eyelid retraction, with facial nerve palsy, Graves eye disease, involutional lower eyelid retraction, and forms of muscular dystrophy the commonest etiologies. RESULTS: Thirty-one (82%) of the 38 MTS procedures were successful. There was no unifying factor among the seven failed procedures in five lids of five patients. Three of the five patients, including two who were operated on twice, ultimately had a successful MTS. This procedure was not repeated on the other two failed patients. Range of follow-up was 9 months to 5.6 years, with a mean of 3.7 years. The mean elevation of the central lower eyelid was 1.6 mm in the successful cases. CONCLUSIONS: Medial tarsal suspension is an effective way to elevate the medial end of the lower eyelid.

Adult↗
PubMed2002

Floppy eyelid syndrome: a modified surgical technique.

PURPOSE: To describe and present the results of a modified surgical technique to repair floppy eyelids. METHODS: A case series of 5 patients who were treated with the modified technique is presented. This technique uses the relaxed skin tension lines to tighten the lids in an aesthetically minded reconstruction. RESULTS: All patients had relief of symptoms and good cosmetic and functional results. Average follow-up was 39 months. Complications were minor and easily treated. CONCLUSIONS: This modified surgical technique provides excellent long-term structural integrity of the wound with a potentially more acceptable camouflaged scar.

Aged↗