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At least 865 records · Page 48Linked to original sources
PubMed2006

Injectable self inflating hydrogel pellet expanders for the treatment of orbital volume deficiency in congenital microphthalmos: preliminary results with a new therapeutic approach.

BACKGROUND/AIM: Children with congenital microphthalmos are usually able to wear an eye prosthesis but the cosmetic aspect is determined by the size of the orbital volume deficiency. Instead of using a ball shaped standard hydrogel expander or a regular orbital implant, which would necessitate enucleation of the microphthalmic eye, this study investigates the feasibility of volume augmentation with injectable pellet expanders, as formerly suggested for acquired anophthalmos in adults only. METHOD: The pellet expander is made from a self inflating hydrogel that takes up water by osmosis (dry state: length 8 mm, diameter 2 mm, volume 0.025 ml; in vitro hydrated state after around 1 day: length 15 mm, diameter 4 mm, volume 0.24 ml; swelling capacity: 9.6-fold). This report concerns six patients (two girls and four boys) aged between 4 months and 42 months with unilateral microphthalmos who were treated by injection of 4-14 pellet expanders into the retrobulbar orbital tissue. Volume augmentation was 1-3.5 ml. The pellets were injected using a customised trocar and placed behind the microphthalmos directed into the intraconal space. RESULTS: The increasing orbital volume was noticeable within 2 days and was confirmed by ultrasonography and magnetic resonance imaging. The final result can be anticipated by the volume augmentation effect produced by the amount of saline solution injected in the orbital apex region. All patients were fitted with an artificial eye, which was subsequently enlarged every 3-5 months. Anophthalmic enophthalmos was fully compensated with this technique. No complications have been encountered to date. CONCLUSIONS: Orbital volume augmentation with injectable self inflating hydrogel expander pellets is apparently a safe, quick, and minimally invasive technique for various indications in orbital reconstructive surgery-for example, to treat an enophthalmic appearance in microphthalmos and congenital or acquired anophthalmos.

Child, Preschool↗
PubMed1997

Clinical experiences with the external tissue extender.

Forty one patients were operated on for different skin defects using the external tissue extender (ETE). The indications were similar to those in which ordinary tissue expanders were used with a prevalence of scars (n = 20, 46%) and previous skin grafts (n = 12, 28%). The ETE was used all over the body but mainly on the upper (n = 18, 42%) and lower (n = 12, 28%) extremities. The mean treatment time was eight days, and the complication rate was 8% compared with the reported 25% using ordinary tissue expanders. The advantages of the ETE compared to ordinary tissue expanders are that it saves time and money for doctors and patients, it is easy to handle, and it is almost always possible to operate under local anaesthesia.

Adolescent↗
PubMed1999

Achieving success with the silicone expander for overacting superior obliques.

PURPOSE: To report the results of and complications with silicone expander surgery for the overacting superior oblique. METHODS: A total of 26 patients with bilateral overaction of the superior oblique and A-pattern strabismus and 5 patients with unilateral overacting superior oblique secondary to inferior oblique palsy were treated with a 7 mm silicone expander. Care was taken not to enter the sub-Tenon's space. RESULTS: The group that underwent bilateral superior oblique surgery had an average preoperative pattern of 37.42 diopters (D) and an average correction of 35.37 D. Three patients had a severe unilateral postoperative inflammatory incident that was successfully treated with oral and topical corticosteroids. One of these patient developed Brown's syndrome. Another patient, who had no postoperative inflammatory incident, also developed Brown's syndrome. In these 4 patients, the sub-Tenon's space was inadvertently entered during surgery. CONCLUSION: The silicone expander surgery has a very high success rate in treating the A-pattern associated with the bilateral overacting superior oblique. This procedure also works well for the unilateral superior oblique that overacts owing to an inferior oblique palsy. No cyclotorsion symptoms occurred after this surgery. However, 4 patients had complications because the sub-Tenon's space was exposed during surgery. With this procedure, there is a learning curve to obtain the skill not to enter the sub-Tenon's space.

Adolescent↗
PubMedDate not supplied

[The use of latex expanders for the formation of a conjunctival space in anophthalmos].

Methods for conjunctival cavity plasty in anophthalmia and their advantages and drawbacks are discussed. The known methods do not always bring about satisfactory results (ensure a stable position of the prosthesis in the cavity). A method for conjunctival cavity formation with latex expanders is proposed. Original designs of expanders for the conjunctival cavity were used. The method is interesting and promising for conjunctival cavity plasty in anophthalmia when the cavity is shrunk.

Anesthesia, General↗
PubMed2000

Reconstruction of congenital microtia by using a tissue expander.

In the conventional reconstruction of microtia, skin grafting is an absolute necessity because of the scantiness of the skin tissue at the affected site. As the result, color- and texture- matching as well as sensory preservation remain to be improved. To solve these problems, we developed a surgical procedure for reconstruction of microtia by using a tissue expander, which allowed us to reconstruct the erect auricle without the need for skin grafting. In this paper, we introduce and discuss our method using the tissue expander with a review of the literature. We operated on a total of 38 patients with microtia. Most of the patients were around 10 years of age, but 3 were adults. Autogenous cartilage was used, and the helix, antihelix, concha, and tragus were reproduced. Initially, 70 ml custom-made expanders were used; after that, 75 ml or 95 ml ready-made expanders were used. The erect auricle was reconstructed by the primary procedure in 33 patients. The reconstructed auricle was satisfactory in color- and texture-matching and had nearly normal sensation. No major absorption of the cartilage has been noted for 15 years, although a slight retraction of the expanded skin was observed in each patient. In conclusion, microtia repair by using a tissue expander is superior to that by conventional procedures in color- and texture- matching and sensory preservation of the reconstructed auricle.

Adult↗
PubMedDate not supplied

[The correction of cryptotia with tissue expanders].

Cryptotia is a congenital abnormality represented by the absence of the retroauricular sulcus in its superior portion. As the physiopathology of the problem involves the lack of skin tissue in the superior part of the ear sulcus, Mulliken suggested for the first time in 1988, the use of skin expanders as a method to obtain the extra skin necessary to correct this deformity. We bring forward our experience in the use of skin expanders in the treatment of three patients with cryptotia, bilateral in one of them. The technical aspects of the operations as well as the types of expanders used are described in detail. In all cases the correction of the cartilagenous deformities, freeing of the superior pole of the ear and redefinition of the retroauricular sulcus were performed. There were no significant complications. There was no change of the initial good results after a two years follow-up.

Adolescent↗
PubMed1992

[Total atrophy of the mandibular alveolar crest. A new therapeutic proposal (the use of a tissue expander) and a clinical case report].

Atrophy of the alveolar crest, meant as a syndrome due to a certain variety of pathogenetic episodes developing in a more or less marked framework of resorption of the alveolar to the maxillary processes, represents an issue of debated and uncertain solution, especially in a view of the extreme degrees of the phenomenon. Various kinds of surgical approach have been suggested over time: among them mention should be made of the onlay graft technique, the osteotomy intervention visor type, the osseous interposition sandwich type, and other methods, which were often the result of a pontered mediation of the above mentioned, and which should have therefore enjoyed their single advantages. In consideration of the different techniques, the results were more or less noteworthy and it was clear, however, that a certain "gap" was still existing between the results aimed to and the results reached. Today, thanks to the tissue-expander technique, combined with the use of alloplasty materials (hydroxylapatite), we can give a new contribution to the solution of this invalidating pathology, thus reaching more complete and lasting results in the plastic reconstruction of the alveolar crest, and avoiding at the same time the disadvantages, even of iatrogenic kind, of an osteotomy intervention.

Aged↗
PubMed1992

Current concerns with collagen for soft tissue augmentation.

The Scientific Board of the California Medical Association presents the following inventory of items of progress in dermatology. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, or scholars to stay abreast of these items of progress in dermatology that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another. The items of progress listed below were selected by the Advisory Panel to the Section on Dermatology of the California Medical Association, and the summaries were prepared under its direction.

Collagen↗
PubMed2006

[Surgical correction of cicatricial deformation of the extremity using the tissue expanding method].

Modern approaches to the treatment of cicatricial deformation of extremity are presented. The results of treatment of 20 patients using the tissue expanding method are adduced. During the expander implantation and dermotension in 20% of patients the complications had occurred. The analysis of the results obtained permits to consider dermotension the method of choice in the treatment of the extremity cicatricial deformation.

Adolescent↗
PubMed1990

Reconstruction of microtia using tissue expander.

In this article, microtia was reconstructed by the use of a tissue expander to obtain a sufficient temporal skin flap that ensures an acceptable contour of the auricle. This article introduces the operative procedure and the authors' experience.

Adolescent↗
PubMedDate not supplied

[Indications for the use of a skin-stretching device].

In the management of surgical or traumatic skin loss the Authors consider an alternative method which involves the use of a tool called skin stretching device. The latter seems easy to apply, atraumatic and the least troublesome for the isolation and detaching of tissues employed in skin repair.

Back↗
PubMed1997

Experience with a make-it-yourself scalp extender with hooks.

BACKGROUND: Silicone scalp extenders have been shown to facilitate the process of scalp reduction surgery. OBJECTIVE: This report demonstrates how scalp extender devices can easily be made in the physician's office out of materials that are commercially available. METHODS: A scalp extender is made by bonding a narrow strip of Dacron-reinforced Duralastic silicone sheeting to each end of a long strip of plain Duralastic silicone sheeting. A stainless steel plate of hooks is then secured to each end of the extender. At the time of the first standard scalp reduction surgery, one extender device about 3.0 x 5.0 cm is placed in the subgaleal plane, in the transauricular direction, with hooks piercing the galea 1 cm caudad to the dense-in-quantity hair fringe margin. The circumferencial approach will accommodate the placement of a second extender device in the anterior-posterior direction to elevate the posterior hair fringe. To prevent adhesion of the galea to the periosteum around the devices, a sheet of plain silicone 15 x 20 cm is placed over the periosteum before the extenders are inserted. The extenders are replaced with shorter devices 3-4 weeks later. RESULTS: Usually the average width of bald scalp can be closed fringe to fringe in three operations as compared with five or six operations when using standard scalp reduction procedures. CONCLUSIONS: The scalp extender device described can be custom made in many different sizes. Its use has significantly changed the author's surgical treatment of pattern alopecia.

Alopecia↗
PubMed1994

Assessment of three different methods of tissue dilation for ceramometal restoration.

Tissue dilation is one of the key factors in obtaining accurate duplication of subgingival finishing lines and hence excellent marginal adaptation of the restoration. Elastic impression materials do not displace the tissue. Therefore, the tissue must be displaced away from the prepared teeth or a small ribbon of the free gingiva must be removed to expose the finishing line before making the impression.

Adult↗
PubMed1998

Fibrin glue as a delivery vehicle for autologous urothelial cell transplantation onto a prefabricated pouch.

PURPOSE: The purpose of the study was to investigate how in vivo expanded urothelium can be transplanted onto a prefabricated capsule-pouch for urinary reconstruction. MATERIALS AND METHODS: Urothelial cells from 40 rats were harvested for culture. A tissue expander was used to induce a capsule-pouch on which the cell culture were reimplanted ten days later. As delivery vehicle we compared standard culture media and fibrin glue. RESULTS: The histology demonstrated viable, multilayered clusters of urothelium cells only in the group using the fibrin glue delivery vehicle. CONCLUSION: We conclude that cultured urothelial cells can be successfully reimplanted onto a prefabricated capsule-pouch via fibrin glue, showing potential for urinary reconstructions.

Animals↗