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Biomedical subjects

Kenneth D Steinsapir

Publications and source records attributed to Kenneth D Steinsapir.

5 recordsLinked to original sources
PubMed2006

Treatment of traumatic optic neuropathy with high-dose corticosteroid.

Based on the favorable clinical results in acute spinal cord injury, high-dose methylprednisolone at an intravenous loading dose of 30 mg/kg followed by a continuous infusion of 5.4 mg/kg/h for 24 or 48 hours has been adopted for the treatment of acute traumatic optic neuropathy (TON). Although there is anecdotal evidence of the efficacy of high-dose corticosteroid in this condition, there are no prospective, randomized trials to attest to its benefit. On the other hand, the largest retrospective study showed no benefit of high-dose corticosteroid treatment of TON. Moreover, subsequent study of such treatment of acute spinal cord injury has disclosed that the clinical benefit is modest and that treatment is actually harmful if administered more than eight hours after injury. A recently reported placebo-controlled randomized clinical trial of high-dose corticosteroids in head injury was stopped prematurely because of a significantly greater mortality in the corticosteroid-treated patients. Recent experimental studies suggest that methylprednisolone may be harmful to the optic nerve. Considering this clinical and experimental evidence, there is no basis for treating TON with high-dose corticosteroid.

Animals↗
PubMed2003

Aesthetic and restorative midface lifting with hand-carved, expanded polytetrafluoroethylene orbital rim implants.

The midface lift represents an important advance in aesthetic and reconstructive surgery. However, the need for reliable fixation along the orbital rim has been a significant challenge. Furthermore, volume is needed at the orbital rim, to compensate for long-term remodeling of the bone of the orbital rim and malar face. A technique using a hand-carved, expanded polytetrafluoroethylene implant that is permanently anchored to the orbital rim with titanium microscrews, creating a site for fixation of the advanced midface soft tissues, was developed. This report presents a retrospective, uncontrolled, case series of 41 consecutive patients who underwent transconjunctival midface operations with these implants, and it addresses a variety of midface aesthetic and reconstructive deficits. Only patients with at least 6 months of follow-up data were included in the study. To date, significant complications have been limited. The complications included two cases of implant palpability, with only one requiring surgical modification. One patient underwent implant removal because of skin breakdown and infection related to recurrent squamous cell carcinoma. One patient required revisional lateral canthoplasty for reasons of symmetry. On the basis of this series, hand-carved, expanded polytetrafluoroethylene implants seem to have significant advantages, compared with previously available orbital rim implants. These advantages include the ability to easily modify the implant for the individual anatomical needs, the creation of a secure anchor for fixation of advanced midface soft tissues, excellent tolerance of the implant material, and the ability to place the implant with limited exposure. The greatest disadvantage is the need for the surgeon to carve the implant, which requires time and carving skill. Despite this limitation, the technique is promising.

Adult↗
PubMedDate not supplied

Deep-fill hyaluronic acid for the temporary treatment of the naso-jugal groove: a report of 303 consecutive treatments.

PURPOSE: To report a 2-year experience of treating the naso-jugal groove with injectable hyaluronic acid gel, using a deep-fill method. METHODS: This was a consecutive, retrospective, nonrandomized case series of patients presenting with concerns involving dark circles, lower eyelid hollows, or other contour irregularities that make up the naso-jugal groove. One author performed all treatments, consisting of transcutaneous injection of hyaluronic acid gel filler, to address the naso-jugal groove. The filler was placed deep on the anterior lip of the orbital rim and molded to the desired shape. RESULTS: Between December 2003 and December 2005, 164 patients (34 male and 130 female) received hyaluronic acid gel filler in the face. Ninety-eight patients were treated just once and 66 had multiple treatment sessions. The mean dose of filler per session was 1.53 +/- 0.8 ml, with 0.84 +/- 0.38 ml divided between the two lower eyelids. The most common complication was localized swelling, followed by bruising, asymmetry, cellulitis (2 cases), and migraine (1 case). There were no cases of visual loss. CONCLUSIONS: Hyaluronic acid gel fillers have had an enormous impact on the practice of cosmetic surgery, and this series demonstrates the usefulness of these fillers for treatment of the lower eyelid and midface. The authors recommend the deep-fill method described as a reliable means of addressing the hollow created by the naso-jugal groove.

Adult↗