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Iatrogenic Damage (iatrogenic + damage)

Distribution by Scientific Domains

Medical Sciences	83%

Selected Abstracts

The Art of Mixing Follicular Units and Follicular Groupings in Hair Restoration Surgery

DERMATOLOGIC SURGERY, Issue 6 2004
Dominic A. Brandy MD
Background. Follicular grafting yields good results, but takes an excessively long time to perform the procedure. Iatrogenic damage can also occur to the follicular units during the dissection phase when two follicular units are very close together. Objective. The objective was to minimize the length of time to perform the procedure and to limit iatrogenic damage to the follicular units during the dissection phase. Methods. A donor strip is divided under a stereoscopic microscope into one-, two-, three-, and four-haired follicular units and three- and four-haired follicular groupings. Three- and four-haired follicular groupings are formed when 2 two-haired follicular units or a three-haired follicular unit and one-haired follicular unit are very close together. These hair grafts are then inserted into incisions that are 1.0 to 2.5 mm in length and are arranged in accordance to the particular hairstyle desired by the patient. Results. The technique used in this article accomplishes consistently excellent results while creating an environment that prevents damage to follicular units that are extremely close together. This technique requires less time and damages fewer follicular units. Conclusions. When performing hair restoration surgery, it is many times counterproductive to use follicular units exclusively. [source]

Endoscopic Sinus Surgery Using Intraoperative Computed Tomography Imaging for Updating a Three-Dimensional Navigation System

THE LARYNGOSCOPE, Issue 2 2000
Monika Cartellieri MD
Abstract Objectives: The use of three-dimensional navigation systems provides information on the structures surrounding the field of operation and thereby reduces the risk of iatrogenic damage. The computed tomography (CT) data conventionally used are provided by preoperative scanning procedures, which means that tissue changes coming about during surgery are not seen on the screen. An intraoperative CT scanning procedure being able to update the CT data could provide a solution. Study Design: Endoscopic sinus operations using an intraoperative CT updating the three-dimensional navigation system were performed on six persons to find out, whether the above is true. Methods: Different parameters, advantages, and disadvantages in the cases of these six patients were compared with a group of 22 patients who underwent conventional endoscopic sinus surgery with different three-dimensional navigation systems without updating the CT data set. Results: The intraoperative CT for updating the three-dimensional navigation system provides useful information for the surgeon. Conclusion: Balancing its advantages against its disadvantages, the updating of the CT data set with intraoperative CT cannot be recommended for conventional standard endoscopic sinus surgery. [source]

The use of vein grafts in the repair of the inferior alveolar nerve following surgery

AUSTRALIAN DENTAL JOURNAL, Issue 2 2010
RHB Jones
Abstract Damage to the branches of the trigeminal nerve can occur as a result of a variety of causes. The most common damage to all divisions of this nerve occurs as a result of facial trauma. Unfortunately, iatrogenic damage to the inferior alveolar branch of the mandibular division of the trigeminal nerve is common because of its anatomical position within the mandible and its closeness to the teeth, particularly the third molar. It has been reported there is an incidence of approximately 0.5% of permanent damage to the inferior alveolar nerve following third molar removal. Extraction of other teeth within the mandible carries a lower incidence of permanent damage. However, damage can still occur in the premolar area, where the nerve exits the mandible via the mental foramen. Dental implants are a relatively new but increasing cause of damage to this nerve, particularly if the preoperative planning is inadequate. CT scanning is important for planning the placement of implants if this damage is to be reduced. Primary repair of the damaged nerve will offer the best chance of recovery. However, if there is a gap, and the nerve ends cannot be approximated without tension, a graft is required. Traditionally, nerve grafts have been used for this purpose but other conduits have also been used, including vein grafts. This article demonstrates the use of vein grafts in the reconstruction of the inferior dental branch of the mandibular division of the trigeminal nerve following injury, in this case due to difficulty in third molar removal, following sagittal split osteotomy and during the removal of a benign tumour from the mandible. In the five cases presented, this technique has demonstrated good success, with an acceptable return of function occurring in most patients. [source]

The gracilis muscle and its use in clinical reconstruction: An anatomical, embryological, and radiological study

CLINICAL ANATOMY, Issue 7 2008
V. Macchi
Abstract The gracilis muscle is used widely in reconstructive surgery, as a pedicled or as a free microsurgical flap, for soft tissue coverage or as a functioning muscle transfer. Many studies, based on cadaver dissections, have focused on the vascular anatomy of the gracilis muscle and provided different data about the number, origin, and caliber of its vascular pedicles. Computed tomographic (CT) angiography of both thighs of 40 patients (35 males and 5 females, mean age: 63 years) have been analyzed to provide a detailed anatomical description of the arterial supply of the gracilis muscle. The gracilis muscle had a mean length of 41 ± 2.1 cm. The principal pedicle enters the gracilis muscle at a mean distance (±SD) of 10 ± 1 cm from the ischiopubic attachment of the muscle. Its caliber shows a mean value of 2.5 ± 0.5 mm, and it is statistically larger when originating directly from the deep femoral artery (45%) than from its muscular branch supplying the adductors, i.e., the "artery to the adductors" (46%) (P < 0.01). A significant correlation between the caliber of the artery of the main pedicle and the volume of the gracilis muscle was found (P < 0.01). The mean number of distal accessory pedicles is 1.8 (range, 1,4,) and the artery of the first of these pedicles shows a mean caliber of 2.0 mm. There is no correlation between either the number or the caliber of the artery of the accessory pedicles and the volume of the gracilis muscle. CT angiography, providing detailed images of the muscular and vascular structures of the thigh of each patient, could be a useful preoperative study for the reconstructive surgeon. It would allow a personalized planning of a gracilis flap, reducing the risk of iatrogenic damage. Clin. Anat. 21:696,704, 2008. © 2008 Wiley-Liss, Inc. [source]

The management of normal tension glaucoma

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 3 2000
Julian Sack MB BS FRACO
Objective: To outline the difficulties in making management decisions associated with normal tension glaucoma. To suggest treatment strategies according to the clinical presentation of the disease. Method: Literature review and findings based on clinical experience. Conclusions: The treatment of normal tension glaucoma involves many difficult decisions including whether to intervene and, if so, when and how to treat. Providing the patient with information is essential to gain co-operation and confidence. At present, the treatment objectives are to prevent further visual field loss by reduction of intraocular pressure by 30 per cent or more. This may be achieved by using medical or surgical regimens. Recently, there has been emphasis on the use of neuroprotective drugs that may act independently of the effect of intraocular pressure lowering. The balance between protecting vision and iatrogenic damage is not always easy. [source]