| 1. |
- Abdiu, Avni, et al.
(författare)
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The nasal alar elevator : A new device that may reduce the need for primary operation of the nose in patients with cleft lip
- 2009
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Ingår i: SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY. - : Informa UK Limited. - 0284-4311. ; 43:2, s. 71-74
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Tidskriftsartikel (refereegranskat)abstract
- To improve the shape of the cleft lip nose preoperatively, we have developed the nasal alar elevator. This has been used routinely since 1996 on all our cleft lip patients who have an asymmetrical nose, from the first week after birth until the date of primary lip surgery. We present our 11-year-long experience of using the device on patients born with complete, unilateral cleft lip. In this study 56 children, born between 1996 and 2006 inclusive, with complete unilateral cleft lip, had preoperative treatment with the elevator. During this 11-year period, continuous evaluation during the preoperative period, and its effects on the cleft lip nose, were evaluated, both preoperatively and postoperatively. Our results show that the preoperative use of the device has led to less need for primary nasal surgery. Instead of having to have a primary rhinoplasty (McComb) together with a lip plasty, as a routine, now only about 30% of the patients need primary surgical correction of the nose. If nasal correction is needed, a rather limited undermining of skin over the ala on the cleft side will often be sufficient. The use of a nasal elevator reduces both the length and the extent of the primary intervention, without compromising the final result.
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| 2. |
- Abrahamsson, Peter, et al.
(författare)
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Periosteal expansion of rabbit mandible with an osmotic self-inflatable expander
- 2009
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa Healthcare. - 0284-4311 .- 1651-2073. ; 43:3, s. 121-125
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to evaluate a new technique for intraoral expansion of soft tissue with a self-inflatable expander in rabbits. We placed a self-inflatable soft tissue expander bilaterally in eight rabbits under the periosteum of the mandible through an extraoral approach. The expander was left to self-inflate for two weeks, after which the animals were killed and specimens collected for histological examination. The self-inflatable soft tissue expanders expanded the periosteum. There were no dehiscences or infections. Histological observations showed no signs of any inflammatory reaction and there was no evidence of bony resorption. New bone had formed at the edges of the expanded periosteum. In the control area no new bone had formed. The osmotic soft tissue expander model for intraoral soft tissue and periosteal expansion suggests a promising way of creating a surplus of soft tissue that can be used to cover bone grafts.
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| 3. |
- Adolfsson, L.E., et al.
(författare)
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Radial nerve entrapment in the upper arm as a cause of lateral arm pain : A report of four cases
- 2001
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 0284-4311 .- 1651-2073. ; 35:2, s. 217-220
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Tidskriftsartikel (refereegranskat)abstract
- Four patients with no history of trauma presented with lateral arm pain, local tenderness, and a tingling sensation at the distal end of the arm when the radial nerve was percussed in the mid-third of the upper arm (Tinel's sign), but no clinical or subjective signs of muscular weakness. They were treated by decompression of the radial nerve in the fibrous canal proximal to the lateral intermuscular septum. Three of the patients had a complete or pronounced reduction in pain, while the fourth had only a slight improvement. Non-traumatic radial nerve entrapment in the upper arm may be the cause of lateral arm pain without clinical signs of muscular weakness.
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| 4. |
- Andersson, Annalena, et al.
(författare)
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Efficacy and safety of axillary brachial plexus block for operations on the hand.
- 2006
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 40:4, s. 225-229
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Tidskriftsartikel (refereegranskat)abstract
- An axillary brachial plexus nerve block by a transarterial approach is commonly used to achieve regional anaesthesia for hand surgery. We designed a retrospective study to evaluate efficacy and safety of the technique for acute and elective operations. Anaesthetic records of 189 of all 5520 patients (1996-2000) who had axillary brachial plexus blocks for hand surgery were reviewed, and results compared with complications recorded in the anaesthetic register and in the hand surgery records. Successful axillary block was achieved in 5128/5520 (93%) of patients, according to anaesthetic charts, and primarily in 157/189 (83%), and after supplementation in 171/189 (90%), according to anaesthetic records. Four patients had a toxic drug reaction or axillary haematoma with a transient neurological deficit. Medical complications were recorded in the anaesthetic register in less than 0.7% of axillary brachial plexus procedures. Axillary brachial plexus block by a transarterial approach is effective and safe in hand surgery.
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| 5. |
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| 6. |
- Arai, Takeru, et al.
(författare)
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Bioartificial nerve graft for bridging extended nerve defects in rat sciatic nerve based on resorbable guiding filaments
- 2000
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 0284-4311. ; 34:2, s. 101-108
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Tidskriftsartikel (refereegranskat)abstract
- A long defect (15 mm) in rat sciatic nerve was repaired with a bioartificial nerve graft composed of a silicone tube and seven synthetic filaments of five types (polyamide, catgut, polydioxanone, and two types of polyglactin, normal and quickly-absorbed) inserted longitudinally into the tube. In all cases in which filaments were used a regenerating bridge was obtained in the tube after three months in contrast to empty silicone tubes, in which no structure was observed. There was a 6% ~ 46% recovery of isometric muscle contractility of the anterior tibial and gastrocnemius muscles with positive pinch reflex test in most cases. Myelinated axons were seen in the regenerating tissue between the filaments but not directly in contact with them, and there were varying numbers of macrophages close to the filaments. Silicone tubes with filaments, regardless of type of filament, induced nerve tissue to regenerate and resulted in functional recovery through a 15 mm nerve gap not achieved with empty tubes. Nerve promoting factors may be applied to the filaments and the model is a valuable tool for further development of artificial nerve grafts.
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| 7. |
- Arino, Hiroshi, et al.
(författare)
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Implantation of Schwann cells in rat tendon autografts as a model for peripheral nerve repair: Long term effects on functional recovery
- 2008
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 42:6, s. 281-285
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Tidskriftsartikel (refereegranskat)abstract
- Cultured Schwann cells in tendon autografts for nerve repair improve the early phase of nerve regeneration in rat sciatic nerves as judged by the rate of axonal outgrowth. We tested the long-term effects on functional recovery using measurements of muscle force, the number of axons and myelination, using morphometry. In addition, we recorded wet weight of the gastrocnemius muscle. Schwann cell cultures were prepared from predegenerated nerves. Ten and 15mm defects in rat sciatic nerves were bridged using bilateral tendon autografts with Schwann cell-seeded tendon autografts on one side, and untreated tendon autografts on the other. Animals were evaluated at six and 12 weeks, respectively. At six weeks, myelination, as judged by G-ratio (ratio of axonal diameter to diameter of nerve fibres), was significantly increased in tendon autografts pretreated with Schwann cells in 10mm defects. No such difference was seen in the 15 mmdefects. We found no difference in functional recovery, other morphometric variables, or muscle weight between the two grafts. We conclude that early effects on nerve regeneration using transplantation of cultured Schwann cells in rat sciatic nerves are temporary. Other strategies are necessary to obtain lasting effects on functional recovery.
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| 8. |
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| 9. |
- Becker, Magnus, et al.
(författare)
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Adult skeletal profile in isolated cleft palate: a comparison of the von Langenbeck and Wardill procedures for primary repair of the palate
- 2001
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 35:4, s. 387-397
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Tidskriftsartikel (refereegranskat)abstract
- Sixty-four adult patients operated on for isolated cleft palate were evaluated with regard to facial skeletal morphology using conventional radio-cephalometry. Dental occlusion was assessed clinically. Forty-two had had a von Langenbeck repair at the age of 7 months and 22 a Wardill repair at 18 months. The mean error of the method was 0.7 degree for angular, and 0.9 mm for linear, measurements. The group with clefts had less maxillary prognathism (s-n-ss), more maxillary inclination (NSL/NL), more retroclined lower incisors (ILI/ML), and shorter total and upper facial heights (n-gn, n-sp) compared with the reference group. Multiple regression analysis was used to evaluate differences between the two treatment regimens. Explanatory variables in addition to surgical technique were sex, severity of cleft, and presence of a velopharyngeal flap. Only one variable, lower incisor inclination (ILI/ML), was different for the two regimens. Ten (24%) in the von Langenbeck group had a lateral cross-bite compared with one (5%) in the Wardill group. Other variables in a multivariate regression analysis were affected by sex and severity of cleft to various degrees. This study showed no obvious differences in facial skeletal morphology that could be attributed to surgical technique. Factors other than technique, including sex, age, and severity of cleft merit attention.
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| 10. |
- Becker, Magnus, et al.
(författare)
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Clinical examination compared with morphometry of digital photographs for evaluation of repaired cleft lips
- 1998
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Ingår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. - : Informa UK Limited. - 1651-2073 .- 0284-4311. ; 32:3, s. 301-306
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-four adult patients who had been operated on as infants for isolated cleft lip underwent clinical examination combined with photographic documentation using a digital camera. The same predetermined protocol comprising 20 variables describing nasolabial appearance was used for both the clinical examination and the computerised evaluation of the images. The correlation between the two methods is described in the present study. The results obtained with the two methods agreed closely. For metric variables the mean coefficient of correlation was 0.73 and when all measurements were combined, it reached 0.98. Likewise, discrete variables showed a close correlation, with a mean kappa value of 0.72. Variables related to muscular dynamics of the lip can for obvious reasons not be judged from photographs. However, the computerised photographic evaluation was able to detect more precisely even minor angular deviations of the nose and to measure areas such as the areas of the nostrils. We conclude that morphometry of digital photographs is a new valuable clinical tool for the assessment of the nasolabial appearance in patients with cleft lip and palate.
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