phenylephrine-hydrochloride and Rupture

Pulled-in-two syndrome (PITS) is a serious intraoperative complication of strabismus surgery in which an extraocular muscle manipulated during the procedure is ruptured and potentially lost. Usually, there is a systemic or local condition that determines muscle weakness when put under tension. If the proximal portion of the broken muscle can be found, it can be reattached to the ocular globe or remaining muscle. If this is not possible, there are multiple varying approaches. We present three cases of PITS of the inferior rectus muscle, treated with good results with anterior and nasal transposition of the inferior oblique muscle. We propose this surgery as another potential technique if the muscle can not be retrieved.

Topics: Humans; Intraoperative Complications; Nose; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Rupture; Strabismus

With the extensive development of endoscopic sinus surgery, iatrogenic medial rectus muscle injury should be treated with caution. Traditional methods to repair a ruptured medial rectus need an anterior orbitotomy approach, with more injury and difficulty in finding the posterior end of the ruptured medial rectus.. To explore a new method to repair a ruptured medial rectus.. Eight cases of iatrogenic medial rectus rupture after endoscopic sinus surgery were reviewed from July 2015 to January 2019. Assisted by image-guided navigation, the ruptured medial rectus was sutured under an endoscopic endonasal orbital approach. Two methods were designed to suture the ruptured medial rectus. Optic nerve and orbital decompression were performed in 5 cases with visual impairment. The extent of exotropia and diplopia were followed up for 5 to 33 months after surgery.. With the help of image guidance, the posterior and anterior ends of the ruptured medial rectus of all patients were pinpointed, and operations using medial rectus anastomosis were successfully completed in 7 patients. The exotropia of these patients was corrected, and they have recovered. The vision of 2 patients recovered. There were no minor or major complications intraoperatively or postoperatively.. Assisted by image-guided navigation, medial rectus anastomosis under an endoscopic endonasal orbital approach is a feasible method. The key to preventing orbital complications is strict professional training, including identification of the Onodi air cell and correct application of powered instrumentation.

Topics: Adult; Anastomosis, Surgical; Endoscopy; Feasibility Studies; Humans; Male; Middle Aged; Nose; Oculomotor Muscles; Optic Nerve; Orbit; Retrospective Studies; Rupture; Surgery, Computer-Assisted; Treatment Outcome

To present four cases of button battery nasal foreign bodies that were referred to an otolaryngology department over a 6-month period.. Four cases are presented and discussed with a review of current literature.. Four children aged 2-4 years who were referred to an otolaryngology department over about 6 months were found to have a button battery in their nose. While there was mucosal damage in all the noses the likelihood of a septal perforation developing appears to be related to the time interval between insertion and removal. The two patients who did not develop a septal perforation had the battery removed after about 90 minutes and 3 days. The two patients who did develop a perforation had the battery removed after 4 hours and 24 hours. Battery thickness may also be important as the patient who had the battery removed at 3 days had a 2 mm thick battery whereas the other three all had a 5 mm thick battery.. As button batteries are ubiquitous it is imperative that consumers and medical practitioners are aware of the risks they pose if placed in the nose, and also elsewhere in the body.. As early removal of a button battery is likely to decrease the chances of a septal perforation developing a nasal foreign body should be considered to be a button battery until proven otherwise.

Topics: Child, Preschool; Diagnosis, Differential; Endoscopy; Female; Foreign Bodies; Humans; Male; Nasal Septum; Nose; Rupture

Juvenile nasopharyngeal angiofibromas are highly vascular, non-encapsulated tumours affecting predominantly young males. These lesions are benign histologically but they may become life-threatening with excessive bleeding or intracranial extension.. The surgical approaches to 22 male patients with nasopharyngeal angiofibromas are reviewed. A modification of midfacial degloving performed without rhinoplasty incisions and lateral osteotomies is described.. The patients' ages ranged between 9 and 26 years (mean 14.9). Three stage I tumours, 8 stage II tumours, 6 stage III tumours and 5 stage IV tumours were included into this study. All stage I lesions and one stage II lesion were treated via transnasal endoscopic approach. A modified midfacial degloving approach was used for the removal of seven other stage II lesions, all six stage III lesions, and three stage IV lesions. A combined midfacial degloving-infratemporal fossa Fisch C-transcranial approach was the route chosen for the remaining two stage IV lesions. The complications encountered in the postoperative course include temporary facial palsy in one patient (following a Fisch C infratemporal resection), mild crusting in the nasal cavity in 8 patients, and facial paraesthesia in 6 patients whose tumours were resected via midfacial degloving, and rupture of the subpetrous part of the internal carotid artery in one patient.. The suggested treatment of juvenile nasopharyngeal angiofibroma consists of an endoscopic transnasal approach for early stage lesions, and a modified midfacial degloving for almost all of the advanced lesions. The latter approach is very useful considering surgical exposure, duration of surgery, cosmetic outcome, and morbidity. It can be combined with an infratemporal approach or craniotomy if necessary.

Topics: Adolescent; Adult; Angiofibroma; Carotid Artery Injuries; Carotid Artery, Internal; Child; Craniotomy; Endoscopy; Facial Paralysis; Frontal Bone; Humans; Male; Nasopharyngeal Neoplasms; Neoplasm Staging; Nose; Nose Diseases; Oral Surgical Procedures; Paresthesia; Postoperative Complications; Retrospective Studies; Rupture; Temporal Bone; Treatment Outcome

Topics: Barotrauma; Ear, Inner; Fistula; Labyrinth Diseases; Membranes; Nose; Rupture

Topics: Accidents, Traffic; Adolescent; Adult; Aged; Casts, Surgical; Child; Child, Preschool; Female; Femoral Fractures; Fractures, Bone; Humans; Ilium; Intestines; Kidney; Leg Injuries; Male; Metacarpus; Middle Aged; Nose; Orbit; Pelvic Bones; Rib Fractures; Rupture; Skull Fractures; Spleen; Splenectomy; Tibial Fractures; Urethra; Urinary Bladder; Wounds and Injuries

Topics: Administration, Oral; Adult; Age Factors; Asphyxia Neonatorum; Birth Weight; Delivery, Obstetric; Extraembryonic Membranes; Female; Fetal Diseases; Humans; Infant Mortality; Infant, Newborn; Injections, Intravenous; Labor Presentation; Labor, Induced; Maternal Age; Nose; Oxytocin; Parity; Pregnancy; Rupture

Topics: Adult; Amniotic Fluid; Bacteriuria; Birth Weight; Cesarean Section; Culture Media; Extraembryonic Membranes; Female; Fetal Diseases; Fever; Follow-Up Studies; Genitalia, Female; Humans; Infant, Newborn; Labor Presentation; Labor, Obstetric; Male; Maternal Age; Methods; Mycoplasma; Mycoplasma Infections; Nose; Parity; Pharynx; Pregnancy; Pregnancy Complications, Infectious; Racial Groups; Rupture; Twins; Urogenital System