RESUMO
The experience with free flaps and conventional reconstructive procedures for 118 patients with Rombergapos;s disease and hemifacial microsomia over a 10-year period is presented. The groin free flap was used most frequently for patients with Rombergapos;s disease, whereas the scapular free flap was used for patients with hemifacial microsomia. The rectus abdominis or the latissimus dorsi free flap was chosen only when additional volume was required. To achieve better contour, secondary procedures, such as defatting the flap, pedicled temporal fascial flaps, cartilage and bone grafts, orthognathic surgery, and bone distraction were performed in severe cases. For patients with Rombergapos;s disease, excellent results were achieved in 35% (n = 28) of mild cases, in 72% (n = 27) out of 38 moderately and in 41% (n = 5) out of 12 severely affected patients. In hemifacial microsomia group (n = 40) excellent results were obtained in 66% of cases.
Assuntos
Assimetria Facial/cirurgia , Hemiatrofia Facial/cirurgia , Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Adulto , Transplante Ósseo , Criança , Feminino , Humanos , Masculino , Microcirurgia , Escápula/transplanteRESUMO
Two hundred free flaps for reconstructing the head and neck regions in 192 patients with non-oncological pathology were studied. Pathological entities included Romberg's disease, hemifacial microsomia, acquired facial palsy, trauma, and burn sequelae. Indications for selecting a specific free flap for reconstructing each case, details of anastomoses, reexploration, flap success, operative time, length of hospitalization, and complications were studied. The long-term results of cosmetic and function were also obtained. Patient age ranged from 6 to 40 years. The most common diagnosis was Romberg's disease 39% (n = 75), followed by hemifacial microsomia 20% (n = 40). The free flap most frequently used was the scapular 32% (n = 64), followed by the groin free flap 21% (n = 42). A total of 190 flaps (95%) were successful, whereas only 10 (5%) were lost. The mean operative time was 5:30 h and the average hospital stay was only 6 days. There were no major complications and no deaths in the study group. The patients were followed for at least 1 year in all cases. It is concluded that free flaps are safe and reliable procedures for reconstructing complex head and neck non-oncological defects.
Assuntos
Queimaduras/cirurgia , Assimetria Facial/cirurgia , Hemiatrofia Facial/cirurgia , Traumatismos Faciais/cirurgia , Lesões do Pescoço/cirurgia , Procedimentos de Cirurgia Plástica , Retalhos Cirúrgicos , Adolescente , Adulto , Queimaduras/complicações , Criança , Contratura/cirurgia , Humanos , Lipodistrofia/cirurgia , Estudos RetrospectivosRESUMO
Ocular exposure, conjunctival irritation and corneal keratitis are disturbing consequences of facial paralysis with lagophthalmos. Many techniques have been described for correcting this condition. A new method for decreasing the palpebral fissure is presented. An ear cartilage graft is interposed between the tarsal plate and the levator palpebrae superioris muscle. 12 patients with paralysis of the orbicularis oculi muscle, as assessed by electromyography, were treated with this technique. The palpebral fissure was decreased by 2-3 mm in all cases. 11 patients showed significant improvement of their eye symptoms. One patient, in whom the palpebral fissure could not be closed sufficiently to protect the eye, required additional lengthening by 4 mm of the cartilage graft and a lateral tarsorrhaphy.
Assuntos
Cartilagem da Orelha/transplante , Doenças Palpebrais/cirurgia , Músculos Faciais/cirurgia , Paralisia Facial/complicações , Cirurgia Plástica/métodos , Adulto , Doenças Palpebrais/etiologia , Doenças Palpebrais/patologia , Pálpebras/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-OperatórioRESUMO
The pathogenesis of local lesions induced by Bothrops picadoi venom was studied at the electron microscopic level. White mice were injected i.m. with 100 micrograms of venom. A strong hemorrhagic action was the earliest and most prominent local effect observed in this study. In skeletal muscle fibers, rupture of the sarcolemma was observed and myofibril structure was drastically affected, showing amorphous masses of myofilaments. Myelin layers in many axons were disorganized.
Assuntos
Venenos de Crotalídeos/toxicidade , Mordeduras de Serpentes/patologia , Animais , Axônios/ultraestrutura , Hemorragia/patologia , Neurônios/ultraestrutura , Ratos , Pele/patologiaRESUMO
Referido al método de desalinización de aguas por electrodiálisis. Se describen dos tipos de membranas que pueden emplearse como barreras para aislar la zona purificada: la membrana catiónica y la membrana aniónica. Se describen, asímismo, una unidad de múltiples comportamientos y las torres de membranas. Luego se menciona el proceso de electrodiálisis inversa, haciendo referencia a los costos de operación, el mantenimiento, las instalaciones y aplicaciones. Finalmente, se enumeran las ventajas de la electrodiálisis inversa
Assuntos
Dessalinização , EletrodiáliseRESUMO
Referido al método de desalinización de aguas por electrodiálisis. Se describen dos tipos de membranas que pueden emplearse como barreras para aislar la zona purificada: la membrana catiónica y la membrana aniónica. Se describen, asímismo, una unidad de múltiples comportamientos y las torres de membranas. Luego se menciona el proceso de electrodiálisis inversa, haciendo referencia a los costos de operación, el mantenimiento, las instalaciones y aplicaciones. Finalmente, se enumeran las ventajas de la electrodiálisis inversa
Assuntos
Dessalinização , EletrodiáliseRESUMO
It is well known that all the different procedures of vagotomy have a great variability in the clinical results and a high incidence of positivity in the Hollander's tests, this probably due to the arrangement of the vagus nerves in the low third of the esophagus and its connection with the mienteric plexus. In a group of ten dogs with a gastric fistula we obtained first a sufficient number of assays with vagal stimulation, later on vagotomy was done at the level of the esophago-gastric union (EGU), getting a decrease in the gastric secretion of hydrochloric acid of 64%, afterwards a second section of the vagus nerves was practiced, five centimeters above the EGU having an inhibition of 90% and finally 95% was attained when the vagotomy was done 15 centimeters above the EGU. It is concluded that it is needed a long vagal resection of the last ten centimeters, instead of the classic section of the nerve at the gastroesophagic union; it is the same case with a parietal cell mass vagotomy.