PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Tarsectomy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

34 records · Page 2Linked to original sources
PubMed1983

[The chondromucosal graft. Its use in the correction of entropion caused by tarsoconjunctival cicatrix, trichiasis and distichiasis].

The use of chondromucosal grafts is the classical treatment for reconstruction of the eyelids, whereas these grafts are less employed for correction of tarso-conjunctival scars due to either disease or surgery. The ideal nasal graft is the triangular cartilage, as its mucosa is more delicate and more adhesive than that of the septum, and it separation and positioning do not involve any problems if certain rules are followed. The technique appears attractive to us, as it is simple to perform, there is a lack of postoperative complications and it is logical (replacing a pathological tissue or a missing tissue by an identical one, keeping the lids framework). It appears to be not enough employed in trachomatous entropion (both eyelids being generally affected). However, the technique is useful: during first intention surgery (whether associated or not with tarsectomy); in all cases of recurrence, where it appears to be the only worthwhile treatment (trachomatous eyelids already operated upon by another method, tarsectomy alone).

Cartilage↗
PubMed1999

Management of severe cicatricial entropion using shared mucosal grafts.

OBJECTIVE: To retrospectively analyze our experience using nasal turbinate and hard palate mucosal grafts as shared buttress grafts between the upper and lower eyelid for reconstruction in severe cicatricial entropion. SURGICAL TECHNIQUES: A horizontal tarsectomy is performed in the upper and lower eyelid approximately 2 mm posterior to the gray line. The distal tarsal segments are then dissected and rotated 180 degrees. A graft of nasal turbinate mucosa or hard palate mucosa measuring 1.5 x 3 cm is harvested. The graft is sutured to the cut edge of tarsus in the upper and lower eyelid. The rotated distal tarsal segment is stabilized against the graft using 5 mattress sutures. After 3 weeks, the graft is split by sharp dissection between the upper and lower eyelids. METHODS: The medical records of 12 consecutive patients, representing 15 shared buttress grafts, were reviewed. There were 5 hard palate and 10 nasal turbinate mucosal grafts placed. Follow-up ranged from 2 months to 7 years. RESULTS: The amount of corneal stipple, as well as subjective patient comfort, improved after eyelid margin reconstruction in 12 of the 15 eyes. One patient's visual acuity improved by more than 2 lines after surgery. There were no cases of failure of graft survival and no complications directly related to the shared graft technique. Recurrent entropion and trichiasis were noted in 3 eyelids more than a year after graft placement, reflecting ongoing cicatrization in these eyelids. Hard palate mucosal grafts were irritating to the corneal surface, requiring removal of the epithelium using a diamond burr and bandage contact lens wear. Nasal turbinate mucosal grafts were better tolerated by the corneal surface and had the added benefit of mucous production. CONCLUSIONS: Eyelid reconstruction using nasal turbinate and hard palate mucosal tissues as a shared buttress graft is a viable treatment option for patients with severe cicatricial entropion. Resolution of trichiasis and mechanical corneal abrasion was noted in 13 (86%) of 15 patients with no specific complications related to the technique. The shared buttress technique successfully autostents the healing eyelid margins, makes good use of the large turbinate mucosal graft, and minimizes trips to the operating room. When the mechanical requirements of eyelid margin reconstruction do not require the sturdiness of hard palate mucosa, nasal turbinate mucosa is a preferable graft tissue because it is better tolerated by the corneal surface and produces mucous.

Adult↗
PubMed1990

Whitnall's sling for poor function ptosis.

Severe unilateral ptosis with poor levator function has previously been treated with maximal levator muscle resection or bilateral or unilateral frontalis suspension. One of us (R.L.A.) has developed a technique called "Whitnall's sling," where only the levator aponeurosis is resected, preserving Whitnall's ligament and its attachments. Whitnall's ligament and the underlying resected levator muscle are sutured to the superior portion of the tarsal plate. This surgery preserves levator muscle, Müller's muscle, and Whitnall's ligament without altering the structures that produce the three-layer tear film. In 69 eyelids operated on between July 1976 and July 1986, in which a minimum of 1 year of follow-up by one of use was obtained, results have been satisfactory and directly related to levator function. We believe this technique to be anatomically and physiologically superior to "maximal levator resection" with similar long-term results. More recent results have shown that the addition of a 5-mm superior tarsectomy provides an additional elevation of 1 to 1.5 mm. Whitnall's sling is best suited for cases where the opposite fissure height is 9 mm or less and levator function of the ptotic eyelid is 3 to 5 mm.

Adolescent↗
PubMed1997

[Fornix reconstruction in ocular pemphigoid with Goretex surgical membrane].

UNLABELLED: After separation of symblepharons in ocular pemphigoid, transplantation of nasal or bucal mucosa is recommended to prevent recurrent lid fusion; however, it is not always successful. BACKGROUND: An 86-year-old patient was referred to our eye clinic because of trichiasis in ocular pemphigoid. In the right eye, the only functional eye, fusion of the lower lid and the globe was present. There was severe trichiasis with multiple lesions of the cornea and beginning neovascularization. The left eye showed complete fusion of the lid fissure and neovascularization of the cornea. To prevent the right eye from suffering the fate of the left, we tried to find a simple surgical method that could easily be performed on the multimorbid patient. METHOD: Under parabulbar anesthesia we separated the lower lid from the globe until free passive motility of the lower lid was achieved. A cut-to-size piece of Gore-Tex surgical membrane was prepared and fixated with resorbable u-sutures on the inner lid. The membrane was left in place for 4 weeks until suture lysis. A silicone tube, which was transitorily fixed to the outer lower lid, had an additional ectropionizing effect. Three months later, lower-lid ectropion surgery was performed, combined with tarsectomy to obtain a long-term effect. RESULT: Six months later the lower-lid fornix had stabilized, and the lid and globe had good motility. The corneal lesions had healed. CONCLUSION: The use of 0.1 mm membrane prevents penetration of cell because of the microstructure. Similar to the "bare sclera" technique, which is used in selected cases in strabismus or pterygium surgery, the inner lid and sclera were epithelialized separately from the remaining conjunctiva. The surgical membrane prevented recurrence of the symblepharon. We think the presented technique is an easy, quick method of preventing recurrence of lid fusion after separation of symblepharons.

Aged↗
PubMed2002

Ptosis caused by pachydermoperiostosis.

A 39-year-old man with pachydermoperiostosis is presented. He had enlarged, thickened upper eyelids that made it difficult for him to open his eyes. Eyelid correction was performed by resecting the excessive skin and orbicularis muscle in a fusiform shape and shortening the levator aponeurosis by plication. A wedge resection of the lateral third of the upper lid shortened the horizontal width and also changed the unpleasant fan shape to a better shape, with a natural curvature of the lid. The authors also performed a 5-mm transconjunctival tarsectomy. Visual impairment was corrected with a satisfactory aesthetic outcome.

Adult↗
PubMed1999

Tarsal switch procedure for the surgical rehabilitation of the eyelid and socket deficiencies of the anophthalmic socket.

PURPOSE: To describe a tarsal transfer procedure, which we have named the "tarsal switch," to correct the eyelid malpositions and camouflage the socket defects of acquired anophthalmos. METHODS: The technique consists of an upper eyelid tarsectomy, with transfer of the autologous tarsoconjunctival graft to the posterior lamella of the lower eyelid. RESULTS: The operation was performed in 21 anophthalmic patients. In 16 patients with eyelid malpositions, excellent results (within 1 mm of the fellow eye) were attained in 100% of the patients with ptosis, and in 88% of patients with lower eyelid retraction. In the remaining 5 patients, orbital volume loss with secondary implant migration, inferior prosthetic displacement and eyelid asymmetry predominated. In these patients the anophthalmic orbital defects and eyelid asymmetry were masked well. Patient satisfaction was high and complications were few during an average follow-up interval of 16 months. CONCLUSION: The tarsal switch procedure is useful in managing the eyelid malpositions and masking the orbital deficiencies of the anophthalmic socket.

Adult↗
PubMed1990

The prevention and treatment of lower lid ectropion following blepharoplasty.

Ectropion and scleral show are the most common complications following lower lid blepharoplasty. Certain conditions predispose patients to ectropion, and these should be evaluated. In some cases, the addition of a wedge tarsectomy or tarsal strip procedure to a blepharoplasty in association with careful technique and postoperative measures is important in prevention of postblepharoplasty ectropion. Postoperative ectropion should initially be treated conservatively with massage. This may be effective up to 6 months postoperatively. If conservative measures fail, the etiology of the ectropion should be addressed. Laxity of the tarsus and canthal ligaments benefit from a horizontal lid-shortening procedure. Where there is vertical shortening from excessive skin resection or scarring of the orbital septum, there should be release and grafting of the deficiency.

Ectropion↗
PubMed1993

A treatment algorithm for neuropathic (Charcot) midfoot deformity.

Forty-nine feet in 47 patients with midfoot neuropathic foot deformity were referred for care to a comprehensive foot salvage clinic and followed for an average of 3.6 years. Twenty-three initially presented without open ulcers. Two underwent elective Syme's ankle disarticulation amputation, and the others were kept ambulatory with a combination of periods of nonweightbearing cast immobilization, accommodative extra-depth shoes with custom orthotics, and ankle-foot orthoses. Twenty-six of the feet initially presented for care with open ulcers and/or chronic osteomyelitis. Twenty-two of these patients underwent 32 surgical procedures. Sixteen underwent debridement of the infected bone and surrounding soft tissues. Excision of large, nonaccommodative boney prominence, termed exostectomy, was performed in eight. Partial excision of the deformed midfoot combined with boney stabilization and attempted arthrodesis, termed partial tarsectomy, were performed in seven. All surgical patients were managed postoperatively with long-term custom accommodative bracing. Follow-up at an average of 3.6 years revealed that all but one of the patients remained ambulatory. Six walk with accommodative shoe gear and persistent stable chronic open ulcers. None required below-knee amputation. Five amputations were performed, three at the Syme's ankle disarticulation level, one at the Chopart's hind-foot level, and one at the mid-foot level.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

The results of pantalar reduction in the management of congenital talipes equinovarus.

One hundred and twenty-five patients with 194 feet affected by congenital talipes equinovarus were treated by the senior author during the period 1959 to 1980. Of these, 70 patients presented either at birth or in the early neonatal period, and 55 were seen later, having been referred from other centres. Seventy-five patients were subsequently reviewed by two of us; the remaining 50 were assessed from records and research files. Patients seen within four weeks of birth were termed "early", the remainder "late". Of the early group of 70 patients, 44 (with 68 affected feet) were reviewed and 26 (with 41 affected feet) were assessed from records. Excellent or good results were achieved in 94 per cent of feet treated conservatively and in 82 per cent of feet which required pantalar release. Of the 55 late referrals 32 patients (with 55 affected feet) were reviewed and 23 (with 30 affected feet) were assessed from records. Satisfactory results were slightly less frequent, but were achieved in 75 per cent of cases. There was no statistical correlation between early soft-tissue release and a good final outcome, but there was a positive statistical correlation between good clinical results and a high talocalcaneal index. Osseous correction (a laterally based wedge tarsectomy or a triple arthrodesis) was necessary at a later date in four feet (four per cent) of those who presented early and in 13 feet (15 per cent) of late referrals.

Adolescent↗
PubMed1994

Blepharoplasty and ptosis.

Recent advances in local anesthetic techniques have led to suggestions that buffered solutions for infiltration increase patient comfort. The use of an eutectic mixture of local anesthetics cream has however proved to be disappointing. The use of monopolar electrocautery, carbon dioxide lasers, and high-frequency radio wave electrosection provide the surgeon with new modes of cutting and coagulation. Lower lid blepharoplasty via a conjunctival approach may avoid many of the complications of the anterior approach. Such complications may also be minimized by careful preoperative planning and frequently the inclusion of a lateral canthopexy in the surgical procedure. The lid height after anterior and posterior levator resection can now be set more accurately with adjustable suture techniques. A new technique combining a superior tarsectomy with levator resection is described. A range of materials for brow suspension are now available. Autogenous fascia lata remains the material of choice when available.

Anesthesia, Local↗
PubMedDate not supplied

Management of myogenic (myopathic) ptosis.

In senile ptosis and late-acquired hereditary ptosis, the Fasanella-Servat procedure is dependable and successful. However, levator resection by the posterior approach is appropriate for the more severe problems. In senile ptosis, a search should be made for signs that might prompt disinsertion repair. The decision for surgery in patients with chronic progressive external ophthalmoplegia or myotonic dystrophy should be made cautiously, and the "optical tarsectomy" should be considerable before conservative levator resection or fascia lata suspension. The patient with myasthenia gravis should be identified, medical evaluation initiated, and except in rare instances, surgery avoided. The more unusual forms of myogenic ptosis should be treated surgically only when the ptosis persists and has stabilized.

Adolescent↗
PubMed1977

[Osteotomy of the calcaneus for pes cavus in childhood].

Osteotomy of the calcaneus (Dwyer procedure) was performed in 14 children (26 feet) aged between 5 and 15 years. On four occasions it was associated with an osteotomy of the first metatarsal and on three occasions with tarsectomy. The technique is described and the results are analysed. The authors conclude that the results were good in children under the age of 10 whilst the feet were still supple. In children over the age of 10, in whom the feet were more rigid, the gait was improved but the cavus deformity was not improved. The best age for operation is between 6 and 10 years.

Adolescent↗
PubMed1992

[Senile ectropion and entropion].

Senile ectropium and entropium are a result of progressive loss of tissue elasticity in the lower lid of the aging patient. In case of ectropium slackening takes place near the lid margin, whereas entropium may develop if this process occurs at a certain distance from the lid margin. Based on these facts, wedge tarsectomy together with a lateral blepharorrhaphy as described by Kuhnt-Blascovicz is the logical treatment for ectropium, while a wedge resection of the tarsus plus formation of a tight muscle sling of the infratarsal portion of the orbicularis muscle is our preferred method to correct the entropium.

Aged↗
PubMed1979

[Flat foot: treatment by sub-talar arthrodesis with reposition of the talus calcaneum (author's transl)].

Since 1962, the authors have used a technique of sub-talar arthrodesis combined with talar-calcaneal reposition ("horseman" operation) in cases of valgus flat foot, accompanied by symptoms, in moderate forms with exaggerated talar-calcaneal divergence and verticalisation of the talus. This operation involves only the sub-talar joint. The mid-tarsal joint is untouched. Technique must be precise in order to avoid hyper or hypo-correction. The results are constantly good. The mid-tarsal joint remains free, which offers a definite advantage in comparison with classical double tarsectomy.

Arthrodesis↗
PubMedDate not supplied

[Trachomatous tarsitis: its consequences and their surgical treatment (author's transl)].

Trachomatous tarsitis is characterized by personal criteria the development of a fibrous and retractile scar tissue inducing cirrhosis with static and hemodynamic changes of the eye lid: lesions of the ciliary stratum, entropion and trichiasis which in their turn give a range of conjunctivocorneal complications, the ultimate stage being xerosis and blindness. To avoid this kind of evolution some easy surgical technics are available. The option between them is mainly oriented by personal criteria and the following pattern may be proposed: -- For upper lid, in regard to degree of tarsis hypertrophy, either Trabut's tarsotomy, or Streatfield-Snellen's tarsectomy, or a joint intervention of Cuenod and Nataf, might be selected. -- For lower lid and in children, the Trabut's transconjunctival tarsotomy is recommended. -- In relapsing cases and when trichiasis prevails over entropion, Van Millingen's marginoplasty will give satisfactory results.

Adult↗