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Abstract
PURPOSE To describe the use of a new, frosted Jones Pyrex tube in the treatment of obstructed canaliculi of the upper lacrimal system. The frosted Jones tube retains the advantages of the traditional smooth Pyrex tube yet appears to improve the positional stability in the surgically created fistula. METHODS Ten patients of a single surgeon who had previously undergone external conjunctivodacryocystorhinostomy and placement of a Jones Pyrex tube, with subsequent Pyrex tube extrusion, were included in the study. All had previous success with Pyrex tubes, with follow-up ranging from 1 month to 14 years. In each case, when the patient presented with an extruded tube, it was replaced with a frosted Jones tube (Weiss Scientific Glass Blowing Company, Portland, OR, U.S.A.). RESULTS In this preliminary study, none of the 10 patients fitted with a frosted Jones Pyrex tube had a recurrence of extrusion. All patients reported proper functioning of the tubes, with no complaints of epiphora or discomfort. CONCLUSIONS Compared with a standard Jones Pyrex tube, a frosted tube functions equally well and reduces the possibility of extrusion, which is the main complication of traditional conjunctivodacryocystorhinostomy. We have exchanged smooth tubes for frosted tubes in patients who have had extrusion of the original tube, and we are currently investigating primary placement of the frosted Jones Pyrex tube.
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652
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653
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Abstract
The indications for removing metal that was implanted in children and the practice of removing it have changed dramatically during the past century, but this subject is rarely discussed in publications, oral presentations, or resident training curricula. Thus, during their training, residents learn about the topic only sporadically from evaluating patients. This article presents the cases for and against metallic implant removal and identifies situations in which removal is appropriate and situations in which it is not.
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654
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Lee VYW, Liu DTL, Lim E, Chan WM, Lam DSC. Management of posteriorly dislocated posterior chamber intraocular lenses by vitrectomy and pars plana removal. Retina 2005; 25:385; author reply 385-6. [PMID: 15805926 DOI: 10.1097/00006982-200504000-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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655
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Pai VS. Dislocation of a polished femoral stem following a cemented total hip arthroplasty: a report of 2 cases. J Orthop Surg (Hong Kong) 2005; 13:73-5. [PMID: 15872405 DOI: 10.1177/230949900501300113] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report 2 cases of hip dislocation after a total hip arthroplasty, which could not be successfully reduced by closed method. Post-manipulation radiographs revealed proximal migration of the prosthesis in both cases, which required open reduction. The pathogenesis and treatment of this hip dislocation is discussed.
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656
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657
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Navani M, Robinson C. Clinical challenge with Implanon ® removal: a case report. JOURNAL OF FAMILY PLANNING AND REPRODUCTIVE HEALTH CARE 2005; 31:161-2. [PMID: 15921567 DOI: 10.1783/1471189053629437] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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658
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De Moor V, De Witte O, Zalcman M, Gelin M, Le Moine O, El Nakadi I. Oesophageal perforation by an anterior cervical fixation device: management in debilitated patients. Acta Gastroenterol Belg 2005; 68:267-9. [PMID: 16013649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Oesophageal perforation following anterior cervical fixation has been reported in the neurosurgical and orthopaedic literature as a rare complication of such procedure. The complications associated with oesophageal perforation may range from minor symptoms to mediastinitis and death. We report two oesophageal perforations following cervical fixation device migration in patients with poor prognosis, managed successfully with conservative surgical and endoscopic techniques.
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659
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Abstract
Oesophageal penetration and migration of foreign bodies are fairly rare occurrences. Most reported cases in the literature involve fish bones, which are eventually found in the lateral neck soft tissue or thyroid lobule. We present a case of a migrating fish bone in an elderly female which was found embedded in her right sternocleidomastoid muscle. The fish bone was successfully removed via neck exploration. Appropriate literature is reviewed.
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660
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Fowble VA, Schuh A, Hoke R, Bitsch RG, Beaulé PE. Clinical correlation of femoral component migration in hip resurfacing arthroplasty analyzed by Einzel-Bild-Röntgen-analyze-femoral component analysis. Orthop Clin North Am 2005; 36:243-50, x. [PMID: 15833462 DOI: 10.1016/j.ocl.2005.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Hip resurfacing arthroplasty using metal-on-metal bearings has become increasingly popular. Wear of these bearings has been imperceptible on plain radiographs. Migration analysis studies may represent the opportunity to detect early failures and evaluate long-term prosthetic survival. The authors retrospectively reviewed 29 hips in a consecutive series of metal-on-metal hip resurfacing arthroplasties with a long-term clinical follow-up (average 8.7 years) to analyze the femoral component migration pattern by means of Einzel-Bild-Röntgen-Analyze-femoral component analysis (EBRA-FCA). Femoral component migrations at 2 years and latest follow-up were compared with the known clinical outcomes. The authors' findings add validity to EBRA-FCA as a means to monitor femoral component migration and the clinical outcome of metal-on-metal hip resurfacing arthroplasty.
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661
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Kalu E, Thonet R. Oligomenorrhoea and contraception despite extrauterine location of the levonorgestrel intrauterine system: a case report. JOURNAL OF FAMILY PLANNING AND REPRODUCTIVE HEALTH CARE 2005; 31:163-4. [PMID: 15921570 DOI: 10.1783/1471189053629455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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662
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663
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Madan AK, Ternovits CA, Tichansky DS. Laparoscopic Removal of Gastric Band after Open Banded Gastric Bypass. Obes Surg 2005; 15:580-3. [PMID: 15946443 DOI: 10.1381/0960892053723259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Open banded gastric bypass has been the choice of some bariatric surgeons. This procedure includes a band (of various materials) around the gastric pouch. While there are advantages to this band, erosion and/or displacement of the band may occur. We describe a case of a symptomatic displaced band which was treated by laparoscopic removal. Laparoscopic removal of the band after open banded gastric bypass is feasible. Revision of previous bariatric surgery may be performed laparoscopically if the technical expertise is available.
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664
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Nadkarni JB, Carden DG. Acute locking in revision total knee arthroplasty due to disengagement of the locking screw. Knee Surg Sports Traumatol Arthrosc 2005; 13:190-2. [PMID: 15824933 DOI: 10.1007/s00167-004-0552-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2004] [Accepted: 04/20/2004] [Indexed: 11/27/2022]
Abstract
Acute locking of the joint in a replaced knee joint is very rare. This report describes an acute locking episode of a revised modular total knee replacement, occurring more than 2 years after surgery. A disengaged screw from the modular femoral component had lodged in the joint at the inferior pole of the patella and required urgent arthroscopic removal. There was no subsequent failure of the stem-condylar junction, nor loosening of the femoral component.
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665
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Sayegh FE, Tsintzas D, Kapetanos GA. Intrapelvic migration of a guide pin during fixation of a hip fracture: who and what is to blame? Acta Orthop Belg 2005; 71:239-41. [PMID: 16152863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The authors report the case of a 61-year-old patient who underwent internal fixation with a dynamic hip screw for a stable intertrochanteric fracture of the right hip. The immediate postoperative radiograph showed complete intrapelvic migration of the threaded guide pin, which has gone unnoticed during operation. The pin was removed by laparotomy, and was found to have damaged no pelvic viscera; the patient made an uneventful recovery. The authors analyse the mechanism of such iatrogenic complications and the possible means to avoid them.
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666
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Kim BM, Osmanovic SS, Edward DP. Pyogenic granulomas after silicone punctal plugs: a clinical and histopathologic study. Am J Ophthalmol 2005; 139:678-84. [PMID: 15808164 DOI: 10.1016/j.ajo.2004.11.059] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2004] [Indexed: 10/25/2022]
Abstract
PURPOSE To describe clinical findings, histopathologic changes, and risk factors for pyogenic granuloma formation complicating silicone punctal plug therapy. DESIGN Retrospective observational case series. METHODS Between November 2000 and April 2004, 903 silicone punctal plugs of the same brand were inserted in 404 subjects. Cases associated with pyogenic granuloma formation were identified and reviewed. Granulation tissue was obtained from 10 patients for histopathologic examination. Multiple risk regression analyses identified factors related to pyogenic granuloma development and factors associated with histologic patterns. RESULTS Pyogenic granuloma development led to the extrusion of 4.2% of all plugs placed in a median time period of 141 days. All patients presented with varying degrees of plug extrusion. Similar distributions of partial and complete plug extrusions, as well as bilateral and unilateral plug extrusions, were seen. Findings at presentation ranged from a subclinical pyogenic granuloma causing partial plug extrusion to a pyogenic granuloma in the punctum with a ring of fibrovascular tissue retaining a completely extruded plug. Histopathologic examination revealed two patterns, representing either acute pyogenic granuloma or involuting pyogenic granuloma. Pyogenic granulomas resolved after 3.1 +/- 1.3 weeks in all patients after plug removal. Multiple regression analysis revealed that large plug size was associated with increased pyogenic granuloma formation (P < .0001). Partial or complete plug extrusion was associated with active or involuting pyogenic granuloma, respectively (P = .023). CONCLUSION Pyogenic granuloma-related spontaneous plug extrusions may be more common than previously thought and can present with a range of clinical findings. The degree of plug extrusion correlates with the histopathologic pattern. Larger plug size and sharp edges in plug geometry may be responsible for pyogenic granuloma formation.
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667
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McAfee PC, DeVine JG, Chaput CD, Prybis BG, Fedder IL, Cunningham BW, Farrell DJ, Hess SJ, Vigna FE. The indications for interbody fusion cages in the treatment of spondylolisthesis: analysis of 120 cases. Spine (Phila Pa 1976) 2005; 30:S60-5. [PMID: 15767888 DOI: 10.1097/01.brs.0000155578.62680.dd] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN This study retrospectively examines outcomes of unilateral transforaminal lumbar interbody fusion (TLIF) with posterior fixation using anterior carbon fiber cages and 360 degrees fusion in spondylolisthesis. OBJECTIVES The goals were to examine the outcomes and perioperative complications of using anterior column support in the treatment of various types of spondylolisthesis. SUMMARY OF BACKGROUND DATA In 2000, Brantigan et al reported the Brantigan interbody fusion cage used as a posterior lumbar interbody fusion in the US IDE clinical trial. This is the largest series to date of TLIF cages specifically used in the treatment of spondylolisthesis. METHODS A comprehensive long-term follow-up study was conducted to evaluate the fusion success and morbidity following implantation with an anterior column support and posterior pedicle screw fixation. The 120 patients with spondylolisthesis were comprised by 11 cases, dysplastic; 58 cases, degenerative; and 51 cases, isthmic-acquired spondylolisthesis. Anterior column support was either a rectangular carbon fiber/PEEK device or a cylindrical carbon fiber/PEEK device. Twenty-eight cases (23%) were revisions. RESULTS There were no pseudarthrosis, instrumentation failures, or significant subsidence at the TLIF level. The disc space height and foraminal height were restored as part of the surgical procedure. Disc height, as measured from the posterior edge of the superior vertebral body, increased from a mean of 5.6 mm before surgery to a mean of 9.3 mm after surgery. Although reduction of the slip was not the primary goal during the surgical procedure for the 120 cases with spondylolisthesis (isthmic-acquired = 51, degenerative = 58, and dysplastic = 11), the 23% slip reduction achieved at surgery was maintained at follow-up. Mean operative time was 143 +/- 33 minutes (range, 70-255 minutes) for all cases. Mean blood loss was 724 +/- 431 mL (range, 300-2,500 mL). There were seven incidental durotomies and three infections. One patient with Grade I degenerative spondylolisthesis required revision of the carbon fiber cage for posterior migration secondary to a traumatic event 3 months after surgery. Fusion success was 98% using the criteriaof Lenke for the posterior fusion and Brantigan and Steffee for the TLIF graft incorporation. CONCLUSIONS Interbody cages in spondylolisthesis are useful to increase neuroforaminal height, to facilitate reduction, and to improve the chances of achieving a successful 360 degrees fusion.
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668
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Horwhat JD, Jowell P, Branch S, Fleishman L, Gress FG. Proximal migration of a 3 French pancreatic stent in a patient with pancreas divisum: suggested technique for successful retrieval. JOP : JOURNAL OF THE PANCREAS 2005; 6:178-84. [PMID: 15767735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
CONTEXT Pancreatic stents may be placed during therapeutic ERCP for a variety of indications. One such indication is to prophylax against the development of pancreatitis following sphincterotomy of the minor papilla in patients with recurrent acute pancreatitis and pancreas divisum. Increasingly, endoscopists that perform pancreatic ERCP are placing small caliber (3 Fr), unflanged, single pigtail stents into the long axis of the pancreatic duct with the expectation that these stents will only stay in place for a few days and the majority will pass spontaneously on their own without the need for follow-up endoscopic retrieval. As such, these stents are generally regarded as safer and associated with a lower rare of complication than larger (5 and 7 Fr), double flanged pancreatic stents. CASE REPORT We present the case of a 3 Fr stent that migrated proximally into the dorsal duct in a patient with recurrent pancreatitis and pancreas divisum. Due to the small size of the patient's dorsal duct, it was difficult to pass appliances alongside the stent to facilitate retrieval and a variety of appliances were used before success was achieved. DISCUSSION The medical literature contains series of proximally migrated larger caliber flanged, pancreatic stents but proximal migration of small caliber, unflanged, pigtail stents has not yet been reported. As the use of these small stents increases, we feel that it is important to highlight the potential for this complication and discuss how we successfully treated our patient.
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669
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Tawfik HA, Budin H, Dutton JJ. Repair of exposed porous polyethylene implants utilizing flaps from the implant capsule. Ophthalmology 2005; 112:516-23. [PMID: 15745784 DOI: 10.1016/j.ophtha.2004.09.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2004] [Accepted: 09/20/2004] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To determine the feasibility of the use of flaps from the capsule surrounding porous polyethylene implants in repairing large or recurrent implant exposures. DESIGN Retrospective, noncomparative, interventional case series. PARTICIPANTS Sixteen patients with exposed porous polyethylene implants. METHODS Vertical and horizontal flaps were created from the implant capsule. These flaps were used to create a double layer of closure to seal the exposure. All patients had a minimum follow-up of at least 12 months. MAIN OUTCOME MEASURES Repair of the exposure without recurrence during the follow-up interval, and assessment of complications. RESULTS At the last follow-up visit, the socket was completely healed in all but 2 patients. In 1 of them, the implant was subsequently exchanged. Other complications included motility loss, conjunctival cyst, and granuloma formation. CONCLUSIONS The use of the implant capsule to salvage exposed porous polyethylene implants is an effective technique; it is associated with some complications that can be minimized by careful case selection.
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670
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Abstract
We report a case of intra-articular fracture of a bioabsorbable fixation device from the femoral tunnel in an anterior cruciate ligament reconstruction using a bone-tendon-bone graft. Thirteen months after successful reconstruction surgery, the patient experienced episodes of locking and medial joint pain. There was no history of trauma and no symptoms of instability or swelling. On revision arthroscopy, a fractured tip of a bioabsorbable RIGIDfix cross pin (Mitek, Westwood, MA) was identified in the medial compartment of the knee. There was a broad area of chondral erosion affecting the medial femoral condyle and a small defect to the medial tibial plateau where the loose body had been lodged. The bone-tendon-bone graft was intact without disruption. After arthroscopy, the patient was symptom free for 3 weeks but then developed further symptoms of locking. Magnetic resonance imaging showed another loose body within the knee. A repeat arthroscopy was performed 6 weeks after the earlier procedure and another piece of the polylactic acid RIGIDfix cross pin was removed, this time from the lateral gutter. This case raises concern about the potential for breakage and resultant loose body formation that may occur after bioabsorbable cross-pin fixation and, particularly, the associated chondral damage that can occur if early intervention is not conducted.
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671
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Bagci S, Tuzun A, Ates Y, Gulsen M, Uygun A, Yesilova Z, Karaeren N, Dagalp K. Efficacy and safety of endoscopic retrograde cholangiopancreatography in patients with Billroth II anastomosis. HEPATO-GASTROENTEROLOGY 2005; 52:356-9. [PMID: 15816434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND/AIMS Endoscopic retrograde cholangiopancreatography (ERCP) procedure is quite difficult to perform in patients with Billroth II anastomosis because of anatomical alterations. The aim of this study is to evaluate retrospectively the results of ERCP applications done in patients with Billroth II operation. METHODOLOGY Out of the 1632 patients who underwent ERCP between 1992 and 2002, 27 (1.65%) had Billroth II operation. The records of these 27 patients were reviewed. Details noted included indications for ERCP, therapeutic interventions, causes of failure and complications. RESULTS Out of the patients, 3 were female and 24 male (mean age 62+/-11). 26 patients had extrahepatic biliary obstruction. 1 patient had an external bile drain. The procedure was carried out 1-5 times (mean 1.5+/-1.1). Cannulation was achieved in 17 patients (62.96%). Out of the patients cannulated, 10 had choledocholithiasis, 4 malign choledochal stricture, 1 chronic pancreatitis, 1 bile leak and 1 periampullary tumor. Success rate of endoscopic treatment was 82.35% (14/17). Proximal migration of the stent and hemorrhage in gastric cardia were the complications observed in the distinct patients. CONCLUSIONS ERCP procedure is quite an effective and safe method for diagnosis and treatment in patients with Billroth II anastomosis and extrahepatic cholestasis in spite of all difficulties.
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672
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Emel E, Karagöz Güzey F, Bas NS, Alatas I, Sel B, Fadillioglu S. Migration of subduroperitoneal shunt into the subdural space: an unusual complication. Pediatr Neurosurg 2005; 41:115-6. [PMID: 15942286 DOI: 10.1159/000085169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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673
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Heimann H, Bechrakis NE, Zepeda LC, Coupland SE, Hellmich M, Foerster MH. Exposure of Orbital Implants Wrapped With Polyester-Urethane After Enucleation for Advanced Retinoblastoma. Ophthalmic Plast Reconstr Surg 2005; 21:123-8. [PMID: 15778666 DOI: 10.1097/01.iop.0000152495.25263.61] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Enucleation is the main form of treatment for advanced retinoblastoma. The major complication of this procedure is orbital implant exposure. Different implants and wrapping materials are currently in use. The aim of the current study was to analyze the complications associated with the use of polyester-urethane, an artificial dura substitute, as a wrapping material for enucleation in advanced retinoblastoma. METHODS A retrospective review of 32 cases (28 patients), who were treated with enucleation for advanced retinoblastoma, was performed. The age of the patients ranged between 3 months and 6.7 years (median, 19 months). Additional chemotherapy was administered in 12 cases. The removed eyeball was replaced either with a silicone implant and polyester-urethane wrapping (13 cases) or hydroxyapatite, silicone-hydroxyapatite, or polyethylene implants without additional wrappings (19 cases). The follow-up period ranged from 7 months to 5.9 years (median, 22.4 months). Statistical analysis was performed using the Kaplan-Meier method. RESULTS Single or multiple exposures occurred in 22% of cases (7/32). There were 6 exposures (46%, 6/13) in the group with polyester-urethane wrapping compared with only 1 exposure (5%, 1/19) in the implants without wrapping. This difference was statistically significant (p=0.0236). None of the other analyzed factors (additional chemotherapy, surgeon, age of the patient, or size of the implant) demonstrated a significant correlation to implant exposures. CONCLUSIONS Wrapping of orbital implants with polyester-urethane resulted in a high rate of implant exposures after enucleation for advanced retinoblastoma. In this series, the best results were achieved with integrated implants without additional wrapping.
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674
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Thomas DA, Khalifa YM. Temporalis Fascia in the Management of Gold Eyelid Weight Extrusion. Ophthalmic Plast Reconstr Surg 2005; 21:153-5. [PMID: 15778673 DOI: 10.1097/01.iop.0000156499.84713.44] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A patient with a traumatic facial nerve palsy and resulting paralytic lagophthalmos underwent surgical implantation of a gold weight load, which extruded 4 weeks after surgery. Cicatricial contraction of the anterior lamella developed, and a full-thickness skin graft was used to correct the cicatrix. A second gold weight loading procedure was then undertaken with a temporalis fascia drape added to reduce the risk of extrusion. One year after surgery, there is no sign of migration or extrusion. Gold weight loading has emerged as the standard in management of paralytic lagophthalmos, with extrusion cited as the most serious complication. We propose temporalis fascia draping as an adjuvant procedure in the reimplantation of an extruded gold weight.
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675
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Rosenblatt P, Pulliam S, Edwards R, Boyles SH. Suprapubically assisted operative cystoscopy in the management of intravesical TVT synthetic mesh segments. Int Urogynecol J 2005; 16:509-11. [PMID: 15735894 DOI: 10.1007/s00192-004-1282-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2004] [Accepted: 12/13/2004] [Indexed: 01/11/2023]
Abstract
The tension-free vaginal tape (TVT) sling has become one of the most common procedures performed for the treatment of female stress incontinence. Perforations of the bladder during the TVT placement are relatively common, but are usually noted on cystoscopy and corrected at the time of the procedure. Undetected perforation may result in several complications including recurrent urinary tract infections, bladder stone formation, and pelvic pain. A novel technique is described using operative cystoscopy with suprapubic assistance, which provides an effective means for resection of intravesical mesh. Unlike traditional approaches via laparotomy, this minimally invasive procedure may allow for successful mesh removal while avoiding the morbidity of an open procedure.
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