Biomedical subjects
Publications and source records attributed to Ruth M Manners.
This report describes simple principles for constructing the bilobed flap in the periocular region. The results in a prospective series of 23 consecutive patients are presented. All patients achieved satisfactory functional and aesthetic results with the use of this technique. These simple principles achieved consistently good results and can enable the surgeon to use this flap with greater confidence.
PURPOSE: To highlight a simple modification of the traditional glabellar flap, which may improve the cosmetic results achieved with this flap by reducing the tendency for the eyebrows to be drawn together. METHODS: The modified surgical technique is described and used prospectively in 10 patients requiring medial canthal reconstruction with a glabellar flap. RESULTS: All patients were satisfied with the cosmetic and functional results. Photographs of one patient illustrate the preoperative and postoperative appearance of the eyebrows. CONCLUSIONS: This simple modification is recommended to avoid drawing the eyebrows together when using the glabellar flap.
PURPOSE: To investigate variability in measurements of axial globe position taken with different exophthalmometers of the same style and manufacturer by the same observer. METHODS: In this small clinical study, 10 Hertel-type mirror exophthalmometers were used to measure the degree of exophthalmos of a plastic head. The deepest points on the lateral orbital margins were marked to ensure accurate placement of the instrument. A single observer, masked to previous measurements, recorded multiple measurements with each instrument over several days. RESULTS: Variation was seen between instruments from different manufacturers and more interestingly, between the same design of instruments from the same company. The measurement of axial globe position varied by up to 2.9 mm between instruments of the same make. There was also variation in the measurement of the relative axial globe position of the model. This measurement varied from 0.6 to 2.4 mm. The mean variation of readings taken with the same instrument was 0.5 mm. CONCLUSIONS: It is already considered good practice to minimize interobserver error by recording the make of exophthalmometer used. This small study also suggests that the same instrument should be used for each examination to minimize error caused by variation between instruments of the same make. Variation of 1.5 to 2.0 mm could affect patient treatment when a difference in measurement of 2 mm is regarded as significant during serial or relative exophthalmometry.
PURPOSE: To identify and summarize the available published literature describing histologic features of congenital blepharoptosis and to consider the evidence for its classification as either a dystrophy or a dysgenesis. A brief overview of etiologic factors is included to highlight the controversy surrounding the cause of the condition. METHODS: Online searches of the current medical literature were performed with the use of search engines provided in British University libraries. Keywords used were ptosis, blepharoptosis, and birth defect, combined with eyelid. Manuscript copies were obtained and translated where necessary. RESULTS: A summary of data found in more than 35 published papers, including theories of etiology (muscular versus neural, genetic versus sporadic, and environmental factors) and evidence for the classification of congenital blepharoptosis as a dysgenesis and as a dystrophy. Study design and data interpretation are commented on where appropriate. CONCLUSIONS: The scarcity of both affected tissue and normal fetal tissue for histologic examination has limited the understanding of the development and classification of congenital blepharoptosis. Each study analyzed had small specimen numbers, highlighting the need for a review of all available data. The available histologic data appear to support the classification of congenital blepharoptosis as a dysgenesis rather than a dystrophy. It is predicted that a greater understanding of the etiology and histology of this condition may distinguish further subtypes. It is also anticipated that a greater understanding of this condition will allow developments in preventive and therapeutic approaches.
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