48 research outputs found
STATIC TREATMENT OF PARALYTIC LAGOPHTALMOS WITH AUTOGENOUS TISSUES
No full textStatic treatment of paralytic lagophthalmos with autogenous tissues.
Pirrello R, D'Arpa S, Moschella F.
Source
Cattedra di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Universitá di Palermo, Via del Vespro, 129, 90138 Palermo, Italy.
Abstract
BACKGROUND:
Long-standing facial paralysis is frequently seen in patients who have undergone surgical procedures with sacrifice of the facial nerve and have never been counseled about limiting its consequences. Lagophthalmos must always be treated in these patients to protect vision. The authors describe their techniques of static treatment for lagophthalmos using autologous tissues and their classification system for standardizing patients.
METHODS:
From July 2001 to September 2005, 12 patients (9 men and 2 women) ranging in age from 37 to 77 years (mean, 58.5 years) were treated. Their paralysis was attributable to acoustic neuroma resection in seven cases, to resection of a cerebral vascular anomaly in two cases, and to total parotidectomy with facial nerve sacrifice in three cases. The patients were treated with elongation of the levator palpebrae superioris muscle using a fascia lata graft, bolstering of the lower eyelid with a conchal cartilage graft, or both, combined with a Kuhnt type resection when needed.
RESULTS:
Complete closure was achieved for nine patients (75%). For all the patients, resolution of symptoms and keratitis was achieved. No complications were observed. The follow-up period ranged from 14 to 51 months (mean, 39.5 months). The cosmetic outcome also was satisfactory.
CONCLUSIONS:
For candidates eligible to undergo static treatment of lagphthalmos, the techniques described may be considered valuable options for the correction of lagophthalmos using autologous tissues, thus avoiding the complications related to alloplastic material implantatio
Lipofilling and platelet rich plasma, Hyaluronic acid and platelet rich plasma: new perspectives for scleroderma patients
No full text
Superior pedicle retroauricular island flap for ear and temporal region reconstruction: anatomic investigation and 52 cases series.
No full textSuperior pedicle retroauricular island flap for ear and temporal region reconstruction: anatomic investigation and 52 cases series.
Cordova A, Pirrello R, D'Arpa S, Moschella F.
Source
Cattedra di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Università degli Studi di Palermo, Palermo, Italy. [email protected]
Abstract
BACKGROUND:
On the basis of a previously published anatomic study on the superior auricular artery (SAA) and on a series of 52 consecutive cases, the authors propose a new superior pedicle retroauricular island flap (SP-RIF) for defects of the upper half of the ear and for temporal region or superficial helical defects.
METHODS:
Twenty five auricular regions were dissected after colored latex injection in the carotid artery of 13 fresh cadavers to investigate the SAA. A SP-RIF was used in 52 consecutive cases after tumor excision. In 51 cases, the defect involved the upper half of the ear. In one case, the defect was in the temporal region.
RESULTS:
The SAA originates either from the superficial temporal artery (44%) or from its parietal branch (56%). Length, caliber, and course have been assessed. Esthetic results of the reconstruction were excellent. There were no major complications in this series. No sequelae at the donor site were recorded.
CONCLUSIONS:
The SP-RIF can be considered as a first choice option to repair nonmarginal losses of substance of the upper half of the ear. Because of its wide arc of rotation, it can also be used for superficial marginal defects of the helix and in selected cases of temporal region defect
The supra-auricular arterial network: anatomical bases for the use of superior pedicle retro-auricular skin flaps
No full textBleeding Prophylaxis in a Child With Cleft Palate and Factor VII Deficiency: A Case Report
No full textBleeding prophylaxis in a child with cleft palate and factor VII deficiency: a case report.
Pirrello R, Siragusa S, Giambona C, D'Arpa S, Cordova A, Moschella F.
Source
Dipartimento di Discipline Chirurgiche ed Oncologiche, Sezione di Chirurgia Plastica e Ricostruttiva, Università di Palermo, Palermo, Italy.
Abstract
The association between factor VII deficiency and cleft palate has never been described. The case of a child with cleft palate and factor VII deficiency who successfully underwent palatoplasty is described in this article. To allow surgical treatment, through maintenance of a normal prothrombin time, the patient was given 15 microg/kg of recombinant factor VIIa every 12 hours, starting 20 minutes before surgery and ending the third postoperative day. No abnormal perioperative bleeding was observed. Use of recombinant factor VIIa in bleeding prophylaxis or treatment is widespread. Doses are much higher in these cases. The reduction of dosage allows easier administration, especially in pediatric patients, without affecting drug efficac
