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Biomedical subjects

F A Nesi

Publications and source records attributed to F A Nesi.

12 recordsLinked to original sources
PubMed1999

Primary orbital angiosarcoma: a case report.

PURPOSE: The pathogenesis, natural history, histopathology, and recommended treatment for orbital angiosarcoma are illustrated and reviewed. METHODS: Case report. RESULTS: A 71-year-old white male presented with bluish discoloration and swelling of the left medial canthal area. A fine needle aspiration and excisional biopsy with histopathologic examination was performed, which showed angiosarcoma. Pattern of growth was demonstrated radiographically and histopathologically, confirming primary orbital angiosarcoma. Subsequent wide surgical resection was carried out, with substantial reconstruction of the left orbital and periorbital area. The patient responded well to the surgery, and was free of tumor after six years of follow-up. CONCLUSION: Angiosarcoma is a rare and highly malignant tumor of epithelial origin. The aggressive nature of this tumor usually results in a high mortality rate despite treatment. However, early diagnosis and wide surgical excision has resulted in successful treatment of these tumors.

Aged↗
PubMed1996

Management of paralytic lagophthalmos with a modified gold-weight implantation technique.

A modified gold-weight implantation technique was used to treat paralytic lagophthalmos in 15 patients. Three patients had suffered extrusions of previously placed gold-weight implants, two had other complications necessitating reoperation, and 10 had no previous surgery. The surgical modifications were intended to reduce the incidence of implant extrusion, postoperative ptosis, and implant visibility beneath the skin. The important changes in the surgical technique included (a) advancing the levator aponeurosis over the implant and (b) adjusting the final eyelid height intraoperatively with levator myotomies. Follow-up ranged from 6 to 11 months. None of the patients in this study had postoperative problems associated with ptosis, implant extrusion, or implant visibility. Mild, prolonged, postoperative edema was noted in several patients. This resolved spontaneously. Mild eyelid retraction and lagophthalmos were seen postoperatively in two patients. This was caused by a failure to perform marginal myotomies at the time of the initial surgeries.

Adolescent↗
PubMed1990

Flap reconstruction techniques in conjunctivorhinostomy.

Dacryocystorhinostomy is usually the standard approach to treat epiphora caused by lower lacrimal tract obstruction. When the pathologic condition lies in the upper lacrimal passage, however, alternate bypass or reconstructive options must be considered. Conjunctivodacryocystorhinostomy, using the Jones tube, can effectively bypass the upper tract, but the technique may be complicated by granulation tissue formation, infection from unapposed mucosal flaps, and inefficient passage of tears through scar as a result of healing by secondary intention. Canaliculodacryocystorhinostomy affords the advantages of a physiologic reconstruction, but is limited by availability of sufficient canaliculus, requires a lengthy and tedious dissection, and must be performed using a microsurgical approach. We describe an alternate technique of conjunctivorhinostomy that provides total lacrimal bypass and has the advantages of bipedicled mucosal flap apposition, temporary stenting, and symptomatic improvement of epiphora. Several case examples illustrate the indications, advantages, and disadvantages of this technique.

Adolescent↗
PubMed1989

Surgical correction of enophthalmos and diplopia. A report of 38 cases.

Enophthalmos, hypophthalmos, and diplopia are complications of orbital injury. This article reviews the causes of these sequelae, describes a method of strategic implantation of bone grafts to the orbit (and malar bone), and reports the long-term (six months to eight years) results in 38 cases. As a result of bone grafting, all but two patients had a correction of the enophthalmos to within 1 to 2 mm of the opposite eye. Of the 20 patients with diplopia, 15 had correction, and an additional four had an improvement of diplopia so it occurred in only one field of gaze. Of the 22 patients with grafts to the malar bone, 16 were thought to have good to excellent results; however, six developed some degree of reabsorption at the graft site. No patients had any decrease in vision. The advantages and disadvantages of the surgical procedure are described and compared with other methods.

Adolescent↗
PubMed1987

Ocular syphilis 1986. Prevalence of FTA-ABS reactivity and cerebrospinal fluid findings.

Serum FTA-ABS tests were obtained for 247 consecutive patients undergoing ambulatory oculoplastic surgery over a 5-month period. The incidence of FTA-ABS reactivity was 52.8%. Cerebrospinal fluid (CSF) from 50 patients with ocular signs of late syphilis and reactive serum FTA-ABS tests was examined. Only 12 (24%) of these patients had reactive serum VDRLs. Thirty patients (60%) had a lymphocytic pleocytosis, elevated protein, or both, in their CSF. No patients had reactive CSF VDRLs. It was concluded that FTA-ABS reactivity is common, serum VDRL tests are inadequate for diagnosing ocular syphilis, and a significant percentage of patients with ocular syphilis have abnormal CSF. More aggressive diagnosis and treatment of ocular syphilis is suggested.

Aged↗
PubMed1986

Posttraumatic enophthalmos and diplopia.

Malposition of the globe and failure to fuse visual images are late-developing complications of orbital injury. This article reviews the causes of specific sequelae, such as enophthalmos, hypophthalmos, and diplopia, and describes a procedure of strategic implantation of autogenous bone grafts to correct the condition(s). Using quantifiable methods of assessing globe position and motility, the authors demonstrate improvement in 18 of 19 patients. Vision is reported unchanged or improved in 13 sighted patients. Several cases are presented with analyses of preoperative and postoperative photographs. Indications, contraindications, advantages, and disadvantages of the surgical procedure are described and compared to others.

Adolescent↗
PubMed1984

New suturing material for medial canthal plication and repair.

This paper describes the use of fine steel wire as a suture material. The suture was developed by the authors for medial canthal plication and repair, and has been used since 1978 in 125 cases. It describes surgical techniques to be used with this suture material.

Child, Preschool↗
PubMed1978

Orbital fractures and medial canthal reconstruction.

An attempt has been made to acquaint the surgeon with the basic principles in the evaluation and treatment of the patient with trauma involving the orbital area. Evaluation must include neurologic, ophthalmic, as well as radiologic examination of the traumatized area. The decision to operate must be based upon the findings in the individual case using sound clinical judgment. Treatment consists of the restoration of the integrity of the traumatized area and the repair of whatever defects may have been caused.

Fractures, Bone↗