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Biomedical subjects

C D McCord

Publications and source records attributed to C D McCord.

8 recordsLinked to original sources
PubMed1992

The tarsal pillar technique for narrowing and maintenance of the interpalpebral fissure.

We describe a tarsorrhaphy technique whereby an ipsilateral upper-eyelid tarsal pillar is sutured to a corresponding lower-eyelid recipient site. This technique allows maintenance of a narrowed interpalpebral fissure indefinitely, yet is easy to reverse without incurring lid-margin damage. Additionally, the procedure can be adjusted postoperatively to either narrow or widen the initial surgical result. We report our combined surgical experience in 35 consecutive procedures using this technique to treat eyes with exposure-related keratopathy of varied etiology, including facial nerve palsies, combined facial nerve palsy and trigeminal neuropathy with an anesthetic cornea, Graves' disease, congenital craniofacial anomalies, and severe keratitis sicca syndrome. The procedure was successful in improving exposure keratopathy symptoms in all 35 cases. Complications, reflecting the authors' learning curve with this new procedure, included intermarginal pyogenic granulomas, stretching of the tarsal pillar, minor lower-eyelid-margin eversion, and tarsal pillar dehiscence.

Adolescent↗
PubMed1979

Techniques in blepharoplasty.

The technique for upper lid blepharoplasty is presented, which emphasizes the creation of a concave, high supratarsal fold by removal of existing preaponeurotic fat pads, excision of a strip of preseptal orbicularis fibers, and portion of the orbital septum. In additon, the skin edges are fixated to the levator aponeurosis just above the tarsus. With this technique, a pleasing result can be obtained, minimizing the amount of skin that is required to excised and introducing a safety factor in the prevention of postoperative lagophthalmos. A skin technique for lower led blepharoplasty is presented which reduces a tendency for "dog-ear" formation with skin closure and minimizes chances of postoperative ectropion. The technique consists of triangulation of the excision of skin from the lower lid to insure an equal-sided wound edge for precise closure and anchoring the lower lid skin flap to the lateral orbital rim. Although the above techniques introduce a safety factor reducing the problem of lagophthalmos in the upper lid and ectropion in the lower lid, they should be considered an "advanced technique" by the occasional blepharoplasty surgeon.

Ectropion↗
PubMed1979

Orbital decompression.

A new technique for exposure of the orbit for decompression of the orbit is described. It may be used for other purposes such as orbital fracture repair, orbital exploration for tumors in the inferior orbit, or reconstruction of the orbit by a variety of methods. The technique provides ready, broad exposure. The approach also avoids not uncommon complications of the eyelid, approaches to the orbit such as skin shrinkage and ectropion of the lower lid. It also results in minimal cosmetic deformity.

Fractures, Bone↗
PubMed1979

Congenital euryblepharon.

Three cases of congenital euryblepharon are presented. In these cases, horizontal width of the eyelid margin is abnormally increased in comparison to the globe and orbit. The 3 cases were all different. One case had involvement of all 4 lids. Another had unilateral involvement of upper and lower eyelids. A third case had bilateral lower lid involvement associated with other anomalies. The additional anomalies which have not been previously reported include a double row of meibomian gland orifices and an extreme lateral displacement of the lower canaliculus and punctum. All cases had varying degrees of vertical shortage of skin in the involved lids leading to lagophthalmos with a mild to moderate exposure keratitis. A review of previously reported cases of euryblepharon is made. The types of surgical procedures used to correct the deformities are discussed.

Child↗
PubMed1979

Exposure of the inferior orbit with fornix incision and lateral canthotomy.

Exposure of the inferior orbit is necessary for exploration of the orbit for repair of orbital fractures, reconstruction of the orbit to correct enophthalmos with a volume implant, and decompression of the orbit to relieve the symptoms and improve appearance in cases of dysthyroid exophthalmos. The usual approach to the inferior orbit has been through a subciliary skin incision and dissection of a skin flap to the orbital rim. A technique is presented which utilizes an inferior fornix conjunctival incision combined with a lateral canthotomy and outward rotation of the lower lid. The advantages of this technique are that it avoids a lengthy skin incision with dissection which may present skin shrinkage if repeated surgery is necessary, employs a very simple closure, and provides better exposure of the nasal, inferior and lateral orbits while leaving the lower lid structures intact, preserving its integrity.

Adult↗
PubMed1978

A combined lateral and medial orbitotomy for exposure of the optic nerve and orbital apex.

A technique for exposure and direct visualization of the optic nerve and medial apex of the orbit is presented. The technique involves an initial lateral orbitotomy or Krönlein procedure followed by a nasal conjunctival peritomy, detachment of the medial rectus muscle, and outward rotation of the globe to expose the optic nerve and apex of the orbit. With relaxing incisions in the conjunctiva, the globe can be rotated approximately 45 degrees with visualization of the optic nerve from its exit from the globe to its disappearance into the origin of the rectus muscles. This technique may be used for exposure of the optic nerve and orbital apex for the optic nerve decompression for chronic papilledema in indicated cases, biopsy of lesions of the orbital apex, or excisional biopsies of tumors of the optic nerve.

Cranial Nerve Neoplasms↗
PubMedDate not supplied

The extruding implant.

In both the treatment and prevention of implant extrusion, exacting surgical technique is necessary. The techniques involved are direct reimplantation of the implant, reinforcement of the tissue with patching and, for additional cosmetic revision, subperiosteal glass bead implantation or fornix reconstruction.

Eye, Artificial↗