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Biomedical subjects

L A Chait

Publications and source records attributed to L A Chait.

At least 19 recordsLinked to original sources
PubMed1991

Use of costal cartilage cantilever grafts in negroid rhinoplasties.

Dorsal augmentation and nasal tip refinement are important objectives in Negroid rhinoplasty. Use of a costal cartilage cantilever graft will achieve these objectives. We report on our experience in 19 patients. The technique offers an excellent solution to supplying the large amount of material often required to adequately augment the dorsum in these patients. The graft is also versatile enough to allow nasal tip refinement. There are additional aesthetic benefits as the cantilever causes a lengthening in the nasal columella, a reduction in the flare of the nostrils, and increases the columellar-labial angle. The procedure is relatively simple to perform. The problem of warping is minimized by symmetrical carving and the use of large grafts with a substantial cross-section.

Anthropometry↗
PubMed1989

A modified frontalis sling in the treatment of combined blepharoptosis and facial nerve paresis.

A surgical method is proposed to treat patients with combined severe blepharoptosis and peripheral facial nerve paresis. The operation involves construction of a sling from the contralateral active frontalis muscle to the affected eyelid tarsal plate. The method has been applied in one patient, with satisfactory results. Re-education of the patient was relatively easy to achieve.

Blepharoptosis↗
PubMed1989

Reconstruction of the alar groove.

The obliteration of a well-defined alar groove is common after nasal alar reconstruction. A method is described that can be used at the time of reconstruction to ensure the continued definition of the groove or to restore it in cases where it has been obliterated. The technique is based on the natural tendency of the skin to tube itself. Cheek skin is advanced beneath the posterior free edge of the reconstructed ala so that this edge now comes into contact with an epidermal surface. As this edge now tends to tube itself, a natural alar groove is produced. This method has been used successfully in six cases.

Aged↗
PubMed1979

An anti-drooling operation in cerebral palsy.

Persistent drooling in cases of cerebral palsy can be successfully controlled by a combination of bilateral parotid duct translocation and bilateral submandibular gland excision. Ten children are described who underwent this operation with satisfactory results. Apart from mile transient postoperative swelling of the cheek, there have been no postoperative complications. The importance of bilateral submandibular gland excision is stressed and the operative details are described. These include elevating a flap of buccal mucosa distally from the orifice of the parotid duct and then burying this strip beneath the buccal mucosa posteriorly to emerge in the pharynx just above the tonsillar fossa. The edges are then sutured to the mucosa of the pharynx. In time the parotid secretions pass into the pharynx via the newly created tube of mucous membrane. The technique is simple and the end result is satisfactory.

Cerebral Palsy↗
PubMed1978

The no-reflow phenomenon in experimental free flaps.

The no-reflow phenomenon was studied following reconstitution of blood flow by microvascular anastomosis in an ischemic and denervated free epigastric flap in the rabbit. Microscopic, histological, angiographic, and hematological studies demonstrated the progressive nature of this obstruction to the peripheral blood flow after increasing periods of ischemia. This obstruction reached a point of irreversibility after 12 hours of ischemia, leading to ultimate death of these flaps. These results are consistent with the hypothesis that an ischemia-induced no-reflow phenomenon is caused by cellular swelling, intravascular aggregation, and the leakage of intravascular fluid into the interstitial space. Similarities between these experimental findings and human observations are made. The clinical importance of early diagnosis and treatment of ischemic tissues is emphasized.

Animals↗
PubMed1978

The effects of the perfusion of various solutions on the no-reflow phenomenon in experimental free flaps.

The effects of solution perfusion in the free epigastric flap of the rabbit, after normothermic ischemic periods of 8 hours or 12 hours, have been examined by operative microscopic and histological methods. A smaller group of animals was also studied in which the perfusion was done before the ischemic insult. An ischemia-related obstruction to the peripheral blood flow occurred in the absence of stagnant ischemic blood in this model. Although the 3 perfusion fluids studied were shown to penetrate to all levels of a flap after such an ischemic period, none of them had a beneficial effect on skin survival. However, the solution containing mannitol did have a protective effect on fat survival. Analogies between these experimental findings and the clinical situation are made, and the importance of the early diagnosis and treatment of ischemia in a flap is emphasized.

Abdominal Muscles↗
PubMed1977

Hallux-to-thumb transfer by microvascular anastomosis.

The replacement of a missing thumb with a big toe transferred as a free vascularized composite graft is described. The anatomical basis relating to this transfer is described and the methods and the advantages and disadvantages of this as alternative thumb reconstruction are discussed. To the best of our knowledge, this procedure is the first of its kind to be undertaken in South Africa.

Adolescent↗
PubMed1977

Free neurovascular flap from the first web of the foot in hand reconstruction.

To identify an anatomically reliable and functionally acceptable neurovascular free flap for use in hand reconstruction, 50 fresh cadaver feet were dissected under the operating microscope, with particular attention paid to the anatomy of the first web area. A distal communicating artery was seen in 100% of dissections, allowing either dorsal or plantar donor artery inflow to nourish the entire flap area. Because of the ease of dissection, the first dorsal metatarsal or dorsalis pedis is suggested as the donor artery, and a dorsal branch of the greater saphenous venous system is suggested as the donor vein. The deep peroneal nerve was seen to consistently innervate the first web and, along with the plantar digital nerves, is suggested as an anatomically identifiable donor nerve. Either part of the foot first web may be used alone or together as a free flap. When indicated further dorsal skin may be incorporated into the web flap to expand its application. Two-point discrimination studies of the lateral plantar surface of the great toe in 50 normal individuals showed an average of 11.2 mm. This was significantly better as a potential donor flap than the medial dorsum of the foot where the average was 32 mm. A single case demonstrating the application of this flap in hand reconstruction is presented.

Adolescent↗
PubMed1977

Preventing the high-riding nipple after McKissock breast reductions.

We reviewed 50 patients who had reduction mamaplasties done by us using the McKissock vertical pedicle technique. The results were satisfactory, except for the high-riding nipple which developed. We describe a minor modification which seems to prevent this complication.

Breast↗
PubMed1976

Skin cover in extensive hand injuries.

The concept of 'axial-based' flaps has revolutionised the replacement of full-thickness defects of the skin and subcutaneous tissue of the hand. The groin flap provides extensive skin replacement, and has the advantage of allowing considerable mobility of the hand, elbow and should during the period of attachment.

Abdomen↗
PubMed1975

Ulceration caused by cytotoxic drugs.

Five cases of severe ulceration of the dorsum of the hand and forearm, caused by the large extravasation of a cytotoxic agent, administered for haematological disorders, are presented.

Adult↗