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Biomedical subjects

S L Bosniak

Publications and source records attributed to S L Bosniak.

At least 19 recordsLinked to original sources
PubMed1992

Dermis-fat orbital implantation and complex socket deformities.

Autogenous dermis-fat grafts implanted within the orbit survive best, with little loss of volume, when they are placed within Tenon's capsule immediately following the removal of the globe; when the rectus muscles (and anterior ciliary arteries) are anastomosed to the dermal edge of the graft; when no cautery has been applied to the recipient bed; and when the anterior diameter of the graft is no larger than 22 mm. Primary grafting in patients without systemic vascular disease is more effective than secondary procedures, performed on patients with fibrotic, compromised recipient beds and without direct apposition of the rectus muscles to the graft.

Adipose Tissue↗
PubMed1991

Cosmetic blepharoplasty.

Performing flawless cosmetic blepharoplasty surgery requires attention to many details. A proper medical work-up with establishment of patient rapport and preoperative photographic documentation should begin the evaluation. The surgical correction of concomittant brow position abnormalities should be considered. Resection of the brow fat pad is useful in recontouring bulky brows and redefining the superior sulci. Upper lid tissue resection needs to be individualized with skin resection, skin muscle resection, and lipocontouring of the suborbicularis muscle as well as with Burows triangles and "W" plasties. Lower lids may be handled by skin flap resection alone, myocutaneous flaps resection, or a combination of both. Lateral tarsal suspension avoids lower skin retraction.

Documentation↗
PubMed1990

Complications of dermis-fat orbital implantation.

Primary dermis-fat implantation can be effectively performed in cases without pre-existing systemic vascular disease or orbital burns. Meticulous handling of the graft (using a Goeller trephine and Tenon's capsule traction sutures), filleting Tenon's capsule, and avoiding cautery of the graft bed may minimize graft necrosis and atrophy. Pyogenic granulomas of the conjunctival-graft interface and graft hirsutism are easily managed. Keratinization of the socket, graft wound dehiscence, donor site hematomas, and wound dehiscence are avoided with careful surgical technique. Secondary dermis-fat orbital implantation may add orbital volume and conserve the conjunctival fornices, but may also suffer a slightly increased frequency and amount of graft absorption.

Adipose Tissue↗
PubMed1990

Abnormalities of the palpebral aperture.

The socket surfaces, conjunctival fornices and palpebral aperture are intimately related. Any socket or fornix abnormality will affect the contour and size of the palpebral aperture. Conversely, a cicatricial lid deformity will alter the depth and contour of the conjunctival fornix. Any surgical correction of a lid malposition must calculate the resultant effect on the socket.

Adipose Tissue↗
PubMed1989

Recognition and management of acute noninfectious dacryocystic retention.

Eleven female and 4 male patients presented with 20 documented episodes of acute noninfectious dacryocystic retention. This syndrome complex consists of severe pain and tearing with minimal but tender distention of the lacrimal sac, without signs of inflammation. It is caused by impaction of a dacryolith in the nasolacrimal duct. In our group of patients, the mean age when seen was 39 +/- 14 years, and the mean onset of symptoms occurred at age 35 +/- 13 years. Six episodes resolved spontaneously, and the rest responded to interventional therapy. In six, irrigation relieved the symptoms. One patient each responded to probing, lacrimal intubation, and primary dacryocystorhinostomy (DCR). In three patients, a new technique of percutaneous nasolacrimal duct dilatation using angiographic techniques relieved symptoms. One patient each failed irrigation and percutaneous dilatation and required secondary DCR. Recognition of this presentation permits differentiation of this syndrome from infectious lacrimal obstruction and allows appropriate therapy. In at least some patients, percutaneous nasolacrimal duct dilatation may offer both a method of accurate diagnosis and an initial alternative to more extensive surgery.

Acute Disease↗
PubMed1989

A comparison of motility: autogenous dermis-fat vs synthetic spherical implants.

The socket and prosthesis motility and the forniceal depths in a group of 47 patients who had undergone enucleation and implantation of synthetic spherical implants were compared with those in a group of 34 patients who had undergone enucleation and implantation of autogenous dermis-fat orbital implants. The primary autogenous dermis-fat orbital implants provided greater socket movement and deeper fornices than the synthetic spherical implants. Prosthesis motility, however, was the same in the two groups.

Adipose Tissue↗
PubMed1988

Radiotherapy of periocular basal cell carcinomas: recurrence rates and treatment with special attention to the medical canthus.

Basal cell carcinomas of the eyelids, especially those in the medial canthal area, may cause extensive local destruction. Recurrent tumours are more aggressive and become progressively more difficult to treat; this is especially true for postirradiated recurrent, medial canthal, basal cell carcinomas. Tumours in this area should thus be treated by a technique which allows tissue sampling in order to gauge the adequacy of the treatment, with the goal being complete extirpation of the tumour. Excision monitored by frozen section control or Mohs' surgery is our recommendation based on a retrospective analyses of 631 eyelid basal cell carcinomas, half of which were primary tumours and half recurrent.

Adult↗
PubMed1987

Trimalar fractures: diagnosis and treatment.

Trimalar fractures of the zygoma are not infrequent midfacial injuries and are a distinct clinical entity. Specific clinical findings include infraorbital anesthesia, trismus, diplopia, enophthalmos, palpable bony suture line abnormalities, flattened malar eminences, and superior sulcus deformities. Six radiologic subgroups have been described. Optimal surgical management and treatment depend on the type of fracture. Three general surgical approaches are currently used: the Gillies technique, the supraorbital approach, and the maxillary sinus approach.

Humans↗
PubMed1987

Reconstruction of the anophthalmic socket: state of the art.

A successfully rehabilitated anophthalmic socket must hold and support a prosthetic device that mimics the contralateral globe. The goal is symmetry. Static symmetry of the palpebral apertures, canthal angles, and superior sulci are basic objectives. Full versions of the socket implant and prosthesis and full upper lid excursion are definitely desirable but difficult to attain. Adequate lid levels and contours and sufficiently deep conjunctival fornices are necessary to keep the prosthesis in place. Buccal mucous membrane and composite dermis-fat grafts as well as vascular pedical flaps can be used to expand contracted sockets. Canthal tendon shortening and fixation can be effectively used to reestablish lid and canthal contours and to support the prosthesis.

Contracture↗
PubMed1986

Correction of true periorbital fat herniation in cosmetic lower lid blepharoplasty.

The presence of puffy, baggy lower eyelids is one of the first signs of the aging face. Baggy eyelids can result from excessive eyelid skin, hypertrophied orbicularis muscle, and/or periorbital fat herniation. An exact diagnosis of which components are contributing to the problem must be made in the preoperative period so that proper correction can be made during surgery. The concept of true periorbital fat herniation in the causation of baggy lower eyelids is presented. The surgical correction of this anatomic defect involves identification and approximation of the dehiscent orbital septum to the capsulopalpebral ligament. Thirty-five patients who presented with true lower eyelid fat herniation and who underwent direct suture repair are reviewed.

Adipose Tissue↗
PubMed1986

Treatment of recurrent squamous papillomata of the conjunctiva by carbon dioxide laser vaporization.

Complete resection of recurrent conjunctival squamous papillomata frequently may be exceedingly difficult, since such lesions are typically friable and multilobulated. Recurrent lesions often fill the fornicies and spill onto the lid margins. Moreover, since the human papillomavirus (HPV) has been linked to some of these lesions, there remains the further possibility of spread with "cold knife" resection. We discuss the benefits of carbon dioxide laser vaporization therapy for recurrent squamous papillomata of the conjunctiva that have not responded to resection and cryotherapy or topical immunotherapy. The carbon dioxide laser facilitates resection by providing a bloodless field, and reduces the possibility of viral seeding of the conjunctiva by sterilizing the operative site and sealing the lymphatics.

Adult↗
PubMed1986

Nonsurgical fat removal in cosmetic blepharoplasty: a new technique.

A new technique of minimally invasive fat removal during cosmetic blepharoplasty is described. This lipolytic diathermy technique has been used successfully in more than 100 patients during the last 3 years and is compared with routine excisional fat removal. The main advantage of this technique lies in its ability to dissolve the fat without surgical excision, thus obviating the inherent complications that arise from such dissection. The technique uses a diathermy unit to cause lipolysis of the fat pockets within their intact septal compartments and can be used for both upper and lower lid herniated fat. This procedure has been found to be exceptionally efficient and predictable and adds another level of safety to cosmetic blepharoplasty.

Adipose Tissue↗