The Journal of craniofacial surgery
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Randomized Controlled Trial
Effects of perioperative remifentanil with controlled hypotension on intraoperative bleeding and postoperative edema and ecchymosis in open rhinoplasty.
This randomized, double-blind study was designed to assess the effect of perioperative remifentanil with controlled hypotension on intraoperative bleeding, postoperative edema, and ecchymosis. ⋯ Remifentanil with controlled hypotension may reduce edema and ecchymosis of the upper and lower eyelids, by reducing mean arterial pressure and amount of bleeding in rhinoplasty.
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The objectives of surgical treatment for microstomia due to cicatricial contracture after burn are to obtain sufficient oral aperture, while maintaining sphincter function of the orbicularis oris muscle, and to secure favorable function for eating and conversation in addition to good oral health. The lips of the mouth have a free border, and the oral aperture, which has been enlarged by the operation, tends to be reduced, because of the actions of the orbicularis oris muscle. When the orbicularis oris muscle is resected, putting a priority on sufficient oral aperture and prevention of redevelopment of contracture, the function of the sphincter is often damaged. ⋯ It would be ideal to take preventive measures against the redevelopment of contracture during surgery. We provided treatment with some ingenious attempts for the nasolabial flap to a patient with microstomia caused by cicatricial contracture after burn. We obtained favorable results with no postoperative use of a splint.
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Cerebrospinal fluid leakage into the orbit (CSF orbitorrhea) or through the orbit to the exterior (CSF oculorrhea) occurs when there is a communication between orbit and subarachnoid space. It has rarely been described. We report a case of CSF oculorrhea following surgery for recurrent sphenoid wing meningioma. ⋯ With wide retraction of eyelids, a 1-cm longitudinal full-thickness laceration through the conjunctiva toward the lateral orbital rim was visualized in the area of the lateral canthal tendon. Steady leakage of pink-tinged serous fluid through the forniceal laceration was observed. With a presumed diagnosis of iatrogenic CSF oculorrhea, the patient was treated conservatively with resolution by postoperative day 6.
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Burns occur in everyday life and cause morbidity and mortality due to delayed healing. Many agents were tried to accelerate healing of burns. The aim of this study was to assess for the first time Sadat-Habdan mesenchymal stimulating peptide (SHMSP) known angiogenesis factor in healing of experimentally created burns in rats. ⋯ Sadat-Habdan mesenchymal stimulating peptide has potential of early healing of experimentally produced burns in rats. Healing was effective and better in the study group compared with the control group, in qualitative and quantitative measures.
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Case Reports
Treatment of acute temporomandibular joint dislocation using manipulation technique for disk displacement.
Temporomandibular joint dislocation is not frequently encountered, but it is often difficult to reduce the dislocation with conventional methods described in textbooks. The key points to success of reduction depend on the patient's position, route of approach, and timing of reducing each side. ⋯ Using our method, temporomandibular joint dislocation can be easily reduced, without using sedative or analgesics. This method is simple, convenient, and worth trying in place of the conventional method.