The Journal of craniofacial surgery
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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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The objective of this study was to retrospectively study the outcomes of large vestibular schwannoma resection through the suboccipital retrosigmoid keyhole approach and emphasize technical details and advantages of surgical resection of large vestibular schwannomas via this approach. ⋯ The suboccipital retrosigmoid keyhole approach is a valid choice for removing large vestibular schwannomas. Through this approach, cerebellopontine angle can be effectively exposed. Skills to protect facial nerve and extensive experience in microsurgical techniques can significantly improve the total resection rate and postoperative facial nerve function. The authors recommend this approach for patients with vestibular schwannomas larger than 3 to 4 cm.
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The aim of this study was to investigate the effects of transseptal suturing against 3 different types of nasal packings with respect to pain, operating time, and postoperative complications after nasal septal surgery. ⋯ Transseptal suturing technique is a useful alternative to packing, with only a minor increase in operating time. Particularly, transseptal suturing shortens extubation time and postoperative care unit stay.
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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.