Complications of fascia lata harvesting for ptosis surgery.
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Blepharoptosis↗
Biomedical subjects
T C Naugle
Publications and source records attributed to T C Naugle.
High leg incision fascia lata harvesting.
OBJECTIVE: The traditional method of harvesting fascia lata has been through an incision above the lateral knee. Problems with this method include a conspicuous scar, herniation of the muscle belly, and hematoma formation. The authors describe a new method of harvesting fascia lata in the region of the hip to minimize these complications. DESIGN: Cohort study. PARTICIPANTS: Twenty-three patients underwent harvesting of fascia lata by the technique described by the authors. Twenty-one patients had ptosis with poor levator function. In two patients, the fascia lata was used to wrap a hydroxyapatite implant. INTERVENTION: The technique for harvesting fascia lata through an incision between the greater trochanter and anterior iliac crest is described. Long-term results were collected from chart reviews and patient interviews after surgery. MAIN OUTCOME MEASURES: The patients were evaluated to determine whether any complications resulted from the new incision site. RESULTS: No permanent complications were noted at the incision site. CONCLUSIONS: Fascia lata can be harvested safely in the region of the iliac crest with an inconspicuous scar and with fewer complications than with the more traditional site slightly above the lateral knee.
Adolescent↗
Free graft enhancement using orbicularis muscle mobilization.
PURPOSE: The purpose of this article is to demonstrate how mobilization of the orbicularis oculi muscle can improve viability, appearance, and function of free skin grafts in the periocular region. By enhancing blood supply with this technique, healing often can be achieved in difficult reconstructive cases. METHODS: Seven patients underwent orbicularis muscle mobilization before placement of free skin grafts. Two patients underwent resection of basal cell carcinomas of the lateral eyelids and canthal region requiring complex reconstructive techniques such as lateral canthal tendon reconstruction with auricular cartilage. One patient underwent upper eyelid reconstruction after total resection for sebaceous cell carcinoma with pagetoid spread. Two patients had difficult wound dehiscences that were difficult to repair primarily. In addition, the lower eyelid with recurrent basal cell carcinomas of two patients who initially had undergone reconstruction with a Hughes procedure was reconstructed using tarsal strip grafts and orbicularis muscle mobilization combined with a free skin graft. RESULTS: All seven patients have viable free grafts to date, and no further problems occurred in the two patients with wound dehiscences. Follow-up ranges from 1 to 8 years. CONCLUSION: Orbicularis oculi muscle mobilization can be combined with a variety of techniques in eyelid and periorbital surgery, including difficult wound repair, reconstruction of the lateral canthal tendon with periosteal flaps or auricular cartilage, tarsal transposition flaps, mucosal grafts, and skin grafts. The addition of this technique can enhance the blood supply to the reconstructed area and allow healing which might not be obtained otherwise.
Adult↗
Lateral canthoplasty.
BACKGROUND. Lateral canthoplasty is one of the most valuable procedures in ophthalmic plastic surgery and has a variety of indications. These include the repair of ectropion, paralytic lagophthalmos, and eyelid retraction. The procedure can also be used in the prevention of some of the above entities, in the delivery of orbital tumors, and is a valuable adjunct in lower blepharoplasty. The tarsal strip procedure is probably the most popular technique of horizontal shortening of the eyelid. OBJECTIVE. Indications for this procedure are reviewed. The technique as I perform it is described in detail.
Eyelid Diseases↗
A superior and inferior orbital rim-based exophthalmometer (orbitometer).
In exophthalmometry when the lateral orbital rim is used as the instrument's fixation base, any alteration in the rim will render serial measurements inaccurate. The exophthalmometer we describe (technically, an "orbitometer") uses the superior and inferior orbital rim areas as a base of reference, making it particularly useful in lateral orbitotomy procedures. This instrument can be aligned at the midpupil horizontally and vertically with a vertical fixation bar. In addition, a vertical bar gradient scale allows measurement of hypoophthalmos and hyperophthalmos.
Anthropometry↗
Ectopic lacrimal gland tissue of the orbit and sclerosing dacryoadenitis.
A 28-year-old man with unilateral proptosis was found to have sclerosing dacryoadenitis and ectopic lacrimal gland tissue of the orbit. The unusual combination simulated invasive adenocarcinoma of the lacrimal gland both clinically and histopathologically. Based on clinical and experimental observations, we propose that the acinar gland atrophy and fibrous replacement of the lacrimal gland and of the heterotopic tissue was the result of a primary developmental abnormality associated with obstruction to normal gland outflow. Physician awareness that ectopic lacrimal gland tissue in the orbit can be affected by sclerosing dacryoadenitis is probably the most critical factor in establishing the correct diagnosis.
Adult↗
Penetrating orbital injury caused by an "Afro comb'.
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Adolescent↗
Alveolar rhabdomyosarcoma of paranasal sinuses and orbit.
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Adult↗