Guerracochran5012
An unsightly scar following cleft repair can undo the good work of even an experienced surgeon. A functioning orbicularis oris muscle beneath the lip scar maintains a zone of dynamic tension resulting in a stretched scar. Botulinum toxin type A (BTA) can be used to create a temporary paralysis of the orbicularis muscle during the healing phase. This may lead to better scar formation after a cleft lip repair.
The present prospective randomized control trial enrolled 28 infants with unilateral cleft lip undergoing primary lip repair. They were randomized to receive injection of either BTA (botox group) or normal saline (control group) intraoperatively into adjacent orbicularis oris muscle immediately after completion of cleft lip repair. Blinded experts reassessed the scar after 6 months. Objective assessment was undertaken employing Visual Analogue Scale (VAS), Vancouver Scar Scale (VSS), and photographic scar width measurements.
Twenty-two subjects were able to complete a follow-up duration of 6 months. independent of cleft lip classification.
This study was designed to evaluate the impact of septoplasty on cardiopulmonary functions in patients with nasal septal deviation (NSD). A total of 30 consecutive adult patients (mean [standard deviation] age 33.7 [10.9] years, 56.7% were males) who underwent septoplasty due NSD were included. Visual analog scale scores, nose obstruction symptom evaluation scale scores, serum N-terminal Pro BNP levels, and cardiologic examination findings on electrocardiogram, transthoracic echocardiography, and exercise treadmill testing were evaluated both 7 days before and 3-months after septoplasty operation. A significant decrease was noted in mean (standard deviation) visual analog scale scores (8.27 [0.83] versus 1.87 [0.73], P < 0.001), and nose obstruction symptom evaluation scores (83.7 [4.9] versus 12.7 [(5.4], P < 0.001) from preoperative to postoperative period, while maximum effort capacity was improved significantly (11.8 [1.9] versus 13.1 [2.1], P = 0.010) after septoplasty. see more Echocardiography findings lmonary artery system and to prevent onset of permanent cardiopulmonary dysfunction via amelioration of chronic obstruction of the upper respiratory tract.
The goal of this study was to compare conventional osteotomes and Magic Saws in terms of edema and ecchymosis, in rhinoplasty patients.
A retrospective, case-control study.
In this prospective, randomized study, we evaluated the results of 258 rhinoplasty patients who underwent osteotomy by either conventional osteotomes or new designed saws called; "Magic Saws." On postoperative days 2 and 7, the patients were photographed by the surgeon; photographs were evaluated by another otolaryngologist, blinded from the osteotomy procedure.
There were no statistically differences between the groups, in terms of age, sex, weight, or average arterial blood pressure (P > 0.05). The postoperative periorbital edema (days 2 and 7) and ecchymosis (day 2) scores were significantly higher in the conventional osteotomy group, as compared to Magic Saw group (P < 0.05). However, on postoperative day 7, the differences in the periorbital ecchymosis scores between the groups, were not statistically significant (P > 0.05).
As compared to conventional osteotomes, Magic Saws were reported to be associated with minimal soft tissue injury, as well as decreased edema and ecchymosis, in the early postoperative period after rhinoplasty.
As compared to conventional osteotomes, Magic Saws were reported to be associated with minimal soft tissue injury, as well as decreased edema and ecchymosis, in the early postoperative period after rhinoplasty.
Through the analysis and evaluation of the size and morphology of teeth and jaws, it is possible to differentiate animal species including man, allowing the theory of human evolution to be established. Hominin evolution is characterized by two main features, the transition to bipedality and the increase in brain size. This had an important impact on the structure and function of the hominine skull. The aim of this article is to retrace the evolutionary steps that led to Homo Sapiens, the direct ancestor of modern man. For the following paper, scientific articles from Medline (PubMed) and Google Scholar database were used from 1929 to 2018. Hominid evolution is characterized by 2 main features, the transition to bipedality and the increase in brain size. The fossils found show that both trends have had an important impact on the morphology and function of the skull of modern man. The basicranial flexion and growth have led to the facial modifications typical of modern man. The main changes concern the mandib, scientific articles from Medline (PubMed) and Google Scholar database were used from 1929 to 2018. Hominid evolution is characterized by 2 main features, the transition to bipedality and the increase in brain size. The fossils found show that both trends have had an important impact on the morphology and function of the skull of modern man. The basicranial flexion and growth have led to the facial modifications typical of modern man. The main changes concern the mandibular evolution with the appearance of the chin, the formation of the Spee curve due to mandibular arch growth, the formation of the temporomandibular joint as a hinge joint with a sliding socket as the condyle and a better function and maximum efficiency than its predecessors thanks to respect for the divine proportions of the face. Knowledge of ontogenesis allows us to know the factors underlying human form and function, analyze and evaluate them in the clinical context.
To explore the characteristics of choroidal tissue in patients with and without central serous chorioretinopathy (CSC) using an automated system of image analysis to determine known and novel metrics.
This was a retrospective case-control analysis of optical coherence tomography (OCT) scans of patients seen at Manchester Royal Eye Hospital, UK, comparing patients with active CSC to an age and gender-matched group with no CSC using a purpose-built automated system of image analysis. The expert system segments and measures established and novel features of choroid using a combination of thresholding, noise removal and morphological techniques.
A total of 72 patients were included in this study, with 40 included in the group with CSC and 32 patient controls with no CSC. There were significant increases from normal to CSC of median choroidal vascular index, 54.7(Median absolute deviation=9.8) to 61.2(4.3) and all choroidal thickness indices including maximum depth, from 249.0(90.1) µm to 372.3(80.3) µm. For novel measures there was a significant increase in tissue entropy from 6.68(0.28) to 6.95(0.17) and area of the largest five vessels from 6.28(3.04) mm2 to 9.10(3.49) mm2. The ratio of vessel lumen to stromal tissue intensity was conversely significantly reduced from 0.674(0.11) in normal patients to 0.59(0.06) in CSC.
The automated system of choroidal analysis expands on the utility of known measures and introduces novel metrics. These findings contribute pathophysiological insights and metrics for further assessment and research on conditions affecting choroidal tissue.
The automated system of choroidal analysis expands on the utility of known measures and introduces novel metrics. These findings contribute pathophysiological insights and metrics for further assessment and research on conditions affecting choroidal tissue.
To compare the visual/anatomical outcomes and feasibility of epiretinal membrane surgery between patients with multifocal or monofocal intraocular lenses (IOLs).
We reviewed the medical records of 46 patients who underwent epiretinal membrane surgery under multifocal or monofocal IOL pseudophakia. The operation time, mean changes in best-corrected visual acuity (BCVA), and central macular thickness (CMT), and complications were compared between the groups.
Macular surgery was performed in 22 and 24 eyes with multifocal and monofocal IOLs, respectively. The total operation time and the total membrane peeling time were similar in both groups (P = 0.125, P = 0.462, respectively). The mean time to create a membrane edge or flap with retinal microforceps was longer for multifocal than for monofocal IOLs (P = 0.013). The mean changes in BCVA and CMT were similar in both groups (P = 0.682, P = 0.741, respectively). Complications were similar between groups.
With multifocal IOLs, vision outside the central surgical field was blurred, requiring more time to create the membrane flap. Retinal surgeons should anticipate the difficulty in precise focusing when creating a membrane flap in macular surgery in patients with multifocal IOLs and should pay more attention to the macular surgery.
With multifocal IOLs, vision outside the central surgical field was blurred, requiring more time to create the membrane flap. Retinal surgeons should anticipate the difficulty in precise focusing when creating a membrane flap in macular surgery in patients with multifocal IOLs and should pay more attention to the macular surgery.
The aim of the study is to compare the efficacy, safety and globe akinesia between retrobulbar anesthesia, Sub-Tenon's anesthesia and medial canthus episcleral anesthesia for 25-Gauge posterior vitrectomy.
A total of 340 25-Gauge vitrectomy data sheets were retrospectively collected between November 2017 and June 2019. Ninety patients were included in the study. These patients were matched by sex and age to receive retrobulbar anesthesia (Group 1, n=30), Sub-Tenon's anesthesia (Group 2, n=30) and medial canthus episcleral anesthesia (Group 3, n=30). Globe akinesia was recorded after the injection of anesthetic at 2, 5 and 10 minute time intervals. Patients were asked to rate the pain during administration of anesthesia, during surgery, and postoperatively using the visual analogue pain scale.
In terms of a perfect block, at 10 minutes retrobulbar outperformed both Sub-Tenon's and medial cantus episcleral anesthesia which appeared quite similar. During administration, the three techniques did not show statistically different effects on pain. Regarding perioperative pain, retrobulbar outperformed medial cantus episcleral anesthesia.
All three techniques allowed for safe surgery. Retrobulbar obtained the best results, even though Sub-Tenon's proved to be a valid alternative. Medial cantus episcleral anesthesia obtained mostly good and fair blocks and acceptable pain levels during surgery. Further studies should investigate whether optimal anesthetic efficacy can obtained with Sub-Tenon's and medial cantus episcleral techniques when higher volumes are used.
All three techniques allowed for safe surgery. Retrobulbar obtained the best results, even though Sub-Tenon's proved to be a valid alternative. Medial cantus episcleral anesthesia obtained mostly good and fair blocks and acceptable pain levels during surgery. Further studies should investigate whether optimal anesthetic efficacy can obtained with Sub-Tenon's and medial cantus episcleral techniques when higher volumes are used.
To compare the anatomical and functional outcomes of drainage through posterior retinotomy (PR) versus perfluorocarbon liquid (PFCL)-assisted drainage in vitreoretinal surgery (VRSx) for rhegmatogenous retinal detachment (RRD) and to study intra-operative and post-operative complications.
This was a prospective randomized study of 52 cases who underwent VRSx for RRD. Group-1 underwent PFCL-assisted drainage through preexisting break while group-2 had PR to drain subretinal fluid. Cases were evaluated for retinal reattachment rates, visual outcomes, optical coherence tomography (OCT) parameters, and postoperative metamorphopsia. The patients were followed up for minimum period of 3-months.
Two groups were comparable in terms of demographic and preoperative parameters. Both groups had single surgery success rate of 100% by the end of follow-up. Final best-corrected visual acuity in group-1 was 0.61 ± 0.33 and 0.61 ± 0.32 in group-2 (p=0.77). OCT parameters (foveal contour, retinal layers, central macular thickness, and epiretinal membrane formation) were similar between the two groups.
