PubMed Health⌕ Search

Biomedical subjects

R M Dryden

Publications and source records attributed to R M Dryden.

At least 19 recordsLinked to original sources
PubMed1992

Worsening of blepharoptosis in downgaze.

We report a group of patients with involutional blepharoptosis most pronounced in downgaze. Retrospective analysis was performed on all patients who underwent involutional blepharoptosis repair in a 30-month period. Physical examination and visual field testing confirmed the increased blepharoptosis in downgaze. The average increase in visual field obstruction is 12.5 degrees and the drop in the upper eyelid relative to the visual axis is 1.9 mm. We conclude that the increased visual field obstruction in downgaze in this subset of patients is significant and deserves clinical evaluation.

Aged↗
PubMed1990

Medial palpebral tendon repair for medial ectropion of the lower eyelid.

The primary functional support for the medial eyelid is from the deep attachments of the orbicularis muscle to the posterior lacrimal crest and lacrimal diaphragm. A dehiscence of the deep medial canthal attachments can alter the position of the lower eyelid with subsequent tearing, medial ectropion, and ocular exposure. In this study, medial palpebral tendon reconstruction was performed on seven lower eyelids with medial instability or ectropion and a dehiscence of the medial palpebral tendon. A periosteal flap left attached to the posterior lacrimal crest was used to replace the attenuated or absent medial palpebral tendon. After a mean follow-up of 7 months, 86% (6/7) of the eyelids had acceptable cosmetic and functional results. The use of a periosteal flap to replace a dehiscence of the medial palpebral tendon has several advantages. The periosteal flap is readily available, strong, and autogenous. The lower eyelid and punctum are pulled tightly against the globe. Lastly, the procedure may be repeated or combined with other ectropion procedures.

Aged↗
PubMed1989

Cerebrospinal fluid leakage complicating orbital exenteration.

In three cases of cerebrospinal fluid leakage complicating orbital exenteration, leakage occurred intraoperatively following relatively low-power (0 to 25 W), high-frequency monopolar cautery to the orbital roof. Six cadaver orbits and 25 dried skulls were examined to investigate possible causes of intraoperative cerebrospinal fluid leakage. In this experimental model, monopolar cautery to the orbital roof did not cause cerebrospinal fluid leakage; however, cautery to preexistent foramina or experimentally created defects in the orbital bones did. In exenteration, monopolar cautery may transmit thermal energy through extant body defects in the orbital roof directly to the dura, resulting in its disruption. These defects may be congenital, tumor related, or iatrogenic. Alternative methods of hemostasis should probably be employed to control bleeding that occurs along the orbital roof during exenteration.

Aged↗
PubMed1989

Intraoperative monitoring of Jones tube function.

If intraoperative visualization is impossible when placing a secondary Jones tube, the presence of tube drainage may confirm correct intranasal positioning. A simple suction method is presented to evaluate the intranasal position of the Jones tube in the anesthetized or uncooperative patient.

Catheterization↗
PubMed1988

Lateral palpebral tendon repair for lower eyelid ectropion.

A dehiscence of the lateral palpebral tendon may cause laxity of the eyelid and result in lower eyelid ectropion. In this study lateral palpebral tendon reconstruction was performed on 45 eyelids with ectropion and lateral palpebral tendon laxity. A periosteal flap from the lateral orbital rim was used to replace the attenuated tendon. After a mean follow-up of 16 months, 91% (41 of 45) of the eyelids had acceptable cosmetic and functional results. Included in this group were 16 eyelids with mild residual ectropion. The use of a periosteal flap to replace an attenuated lateral palpebral tendon has several advantages. The periosteal flap is readily available, strong, and autogenous. The lateral canthus is pulled posteriorly and laterally keeping the eyelid against the globe. Lastly, the procedure may be repeated or combined with other ectropion procedures.

Adult↗
PubMed1988

Medial canthal salivary gland tumor.

Terminal duct adenocarcinoma, of minor salivary gland origin and arising from the base of the nose, eroded through the lateral nasal bone to present as a medial canthal mass. Although rare, these tumors should be considered in the differential diagnosis of periorbital adnexal masses.

Adenocarcinoma↗
PubMed1987

Where is the gray line?

The gray line is a well-known surface anatomic landmark used by surgeons in the repair of lacerations involving the lid margin. To the best of our knowledge, no description of any deep or superficial anatomic counterpart of the gray line has been previously reported. We examined block resections of 51 eyelids histologically following localization of the gray line. The visualized gray line was consistently seen to correspond histologically to the most superficial portion of the orbicularis muscle, known as the muscle of Riolan. We comment on changes in gray line morphology with lid movement, and we advance a hypothesis to explain its "gray" color.

Eyelids↗
PubMed1986

Management of complicated ptosis with contralateral levator recession.

We describe a unique approach to complicated unilateral minimal ptosis. Three cases of unilateral ptosis were successfully managed with the technique of contralateral levator recession. Contralateral levator recession is a useful procedure heretofore undescribed, to our knowledge, for the management of ptosis.

Adolescent↗
PubMed1986

Pseudoepiphora from cerebrospinal fluid leak: case report.

A 4-year-old tearing child with obstruction of the nasolacrimal duct was treated with dacryocystorhinostomy three years after naso-orbital injury. However, what appeared to be tearing persisted, and meningitis developed. Coronal CT scans demonstrated traumatic encephalocele of the posterior superior orbital roof. A chronic orbital cerebrospinal fluid (CSF) leak was diagnosed. To our knowledge no case of chronic CSF leak has been reported that simulated tearing in an otherwise asymptomatic child. In the tearing patient who has a naso-orbital fracture the possibility of chronic CSF leak should be considered.

Cerebrospinal Fluid↗
PubMed1985

Total internal reflection for positioning Jones tube.

Visualization of the Jones tube in the internal nose often poses difficulty for the surgeon and threatens the success of the operation. Postoperatively, localizing the end of the tube in the nose in order to confirm its placement or to analyze the cause of failure may also be technically challenging. A method of visualizing the tube in the nose under both surgical and postsurgical conditions is herein described.

Dacryocystorhinostomy↗
PubMed1985

The preauricular skin graft in eyelid reconstruction.

The skin obtained from the preauricular graft for reconstruction of eyelid and midfacial defects is an excellent tissue and color match for the lower eyelid and medial canthus. This area is an excellent alternative graft site, and its usage should be added to the ophthalmic plastic surgeon's therapeutic armamentarium.

Basal Cell Carcinoma↗
PubMed1985

Temporary nonincisional tarsorrhaphy.

A simple and effective method of temporary tarsorrhaphy, which is referred to as intermarginal serpentine temporary tarsorrhaphy, is presented. The tarsorrhaphy is created by passing a 6-0 Prolene suture in a serpentine manner across the eyelids, entering and exiting from the eyelid margin. This type of tarsorrhaphy is easy to perform, has few disadvantages, and is very effective.

Eyelids↗
PubMed1985

A new technique of indirect ophthalmoscopy for the eye plastic surgeon.

The coaxial fiberoptic headlight used by the lacrimal and orbital surgeon is an excellent light source for visualization of the retina. When employed in conjunction with a condensing lens, an inverted stereoscopic aerial image is produced. The eye plastic surgeon might therefore routinely examine the dilated patient in conjunction with lacrimal or orbital surgery.

Humans↗
PubMed1985

Visualization of the probe tip during lacrimal outflow system probing and intubation.

Probing of the lacrimal outflow system is commonly performed by ophthalmologists for treating nasolacrimal duct obstruction in infants or for intubating the lacrimal system. Visualization of the probe tip in the inferior meatus during probing insures the surgeon of reaching the nose with the probe. Similarly, visualization of the probe is the key to success in intubation irrespective of the retrieval system used. Rotation of a curved metal probe plus infracturing of the inferior turbinate after shrinking the nasal mucosa with cocaine allows such visualization in most instances.

Adult↗
PubMed1983

Nonincisional correction of epiblepharon and congenital entropion.

Nonincisional suture techniques are used for the treatment of epiblepharon and congenital entropion. An explanation for the unstable eyelid seems to involve similar developmental anomalies of the eyelid retractor. Congenital entropion has been treated promptly in the past. Contrary to tradition, symptomatic epiblepharon should also be treated early.

Child↗