Study of Adverse Events of Endotracheal Intubation / 中国医疗器械杂志

OBJECTIVE@#In order to further decrease and reduce the serious adverse events of silicone rubber endotracheal intubation in clinical use, especially in anesthesia and intensive care.@*METHODS@#Through the first stage analysis on the registration and certification of endotracheal intubation products in China, adverse events of products in recent five years in Zhejiang province, domestic and foreign literature of adverse events of products, retrieval of product citation standards, content integrity of product instructions, and expert seminar on serious adverse events, combined with the air leakage of endotracheal intubation products in recent two years, product material and clinical application with normative aspects.@*RESULTS@#Silicone rubber endotracheal intubation products in clinical intensive care have certain clinical safety risks, especially for long-term use of critically ill patients.@*CONCLUSIONS@#According to the four cases of serious adverse events of silicone rubber endotracheal intubation in the clinical intensive care unit, we put forward some suggestions for the manufacturers, clinical users and regulatory agencies to further decrease and reduce the serious adverse events of silicone rubber endotracheal intubation.

Influence of the cotton and silastic seton on the distance of the anal sphincter cables after fistulotomy in rats / Influência do sedenho de algodão e silastic no afastamento dos cabos musculares do esfíncter anal após fistulotomia em ratos

Abstract Rationale: Fistulotomy is a procedure widely used in the treatment of anal fistulas but is associated with varying degrees of fecal incontinence that could be minimized by previous use of sedentum, and the material used may influence the outcome. Purpouse: To compare cotton and silastic used as setons in the spacing of the sphincter cables of rats subjected to fistulotomy. Method: Thirty Wistar rats were used, which after 30 days of fistula production were distributed in: Control Group (GC): the steel wire was removed, followed by fistulotomy; Cotton Group (GA) and Silastic Group (GS), in which were applied cotton and silastic setons respectively for 30 days when fistulotomy was performed; after seven days, euthanasia and removal of the specimens were performed for histological study, and the results were submitted to statistical assessment using Kruskal-Wallis non-parametric test, establishing a significance level of p < 0.05. Results The distance between the muscular cables was 107.9 µm in the GC, 82.4 µm in the GA and 53.5 µm in the GS (p = 0.00001). The mean inflammation scores were 1.9 in the CG, 1.0 in the GA and 0 in the GS (p < 0.05). The fibrosis scores were 1.1 in GC, 0.9 in GA and 0.6 in GS (p > 0.05). Conclusion The silastic seton prior to fistulotomy caused less detachment of the muscular cables and less local inflammatory process.

Resumo Racional: A fistulotomia é um procedimento muito utilizado no tratamento das fístulas anais mas está associado a graus variáveis de incontinência fecal que poderia ser minimizado pelo uso prévio de sedenho, sendo que o material utilizado pode ter influência no resultado. Objetivo: Comparar os fios de algodão e sonda de silastic utilizados como sedenhos no afastamento dos cabos musculares do esfíncter anal de ratos submetidos a fistulotomia. Método: Utilizou-se 30 ratos Wistar, que após 30 dias da confecção da fístula foram distribuídos em: Grupo Controle (GC): foi retirado o fio de aço seguido por fistulotomia; Grupo Algodão (GA) e Grupo Silastic (GS), nos quais aplicou-se sedenho de algodão e silastic respectivamente por 30 dias quando foi realizada fistulotomia; após sete dias realizou-se eutanásia e remoção dos espécimes para estudo histológico, sendo os resultados submetidos a tratamento estatístico pelo teste não-paramétrico de Kruskal-Wallis, estabelecendo-se como significante p < 0,05. Resultados O afastamento entre os cabos musculares foi 107,9 µm no GC; 82,4 µm no GA e 53,5 µm no GS (p = 0,00001). As médias dos escores de inflamação foram 1,9 no GC; 1,0 no GA e 0 no GS (p < 0,05). Os escores de fibrose foram 1,1 no GC; 0,9 no GA e 0,6 no GS (p > 0,05). Conclusão O sedenho de silastic previamente à fistulotomia causou menor afastamento dos cabos musculares e menor processo inflamatório local.

Prevention of laryngeal webs through endoscopic keel placement for bilateral vocal cord lesions / 医学前沿

Transoral microresection for treatment of vocal cord lesions involving the anterior commissure may result in anterior glottic webs. In this study, we retrospectively reviewed 54 patients who underwent microsurgery for bilateral lesions involving the anterior commissure and categorized them into two groups. The keel placement and control groups received endoscopic keel placement and mitomycin C, respectively. During the follow-up of at least 1 year, the laryngeal web formation rate significantly decreased in the keel placement group compared with that in the control group (18.6% versus 54.5%, P < 0.05). Furthermore, the voice handicap index-10 scores for patients without web formation decreased in both the keel placement and control groups (P < 0.0001 and P < 0.001, respectively). A pseudomembrane covering the vocal cords was detected in 16.3% (7 of 43) cases after keel removal. A total of 100% (7 of 7) of these cases and 2.8% (1 of 36) of the other cases formed laryngeal webs (P < 0.0001). Endoscopic keel placement could be an effective method for preventing anterior glottic webs after surgery for bilateral vocal cord diseases involving the anterior commissure. The pseudomembrane observed at the time of keel removal may imply a high risk of web formation.

Use of Suspension Laryngoscopy CO2 Laser Combined with Placement of Silastic Keel for the Treatment of the Vocal Cords Adhesion / 听力学及言语疾病杂志

Objective To investigate the use of suspension laryngoscopy CO2 laser combined with the placement of laryngeal stent for the treatment of the vocal cords adhesion.Methods A total of 21 patients with acquired vocal cords of adhesion patients(The causes were previous vocal fold surgery for benign lesions in 16 cases,the laryngeal surgery for recurrent papilloma in 4 cases,the laryngeal trauma in 1 case)were included in this retrospective study.Under general anesthesia with intubation,following glottis exposure under suspension laryngoscopy,a CO2 laser incision was performed under microscopy on the superior face of one vocal fold,from the anterior commissure to the posterior part of the web.The keel was placed into the larynx to the appropriate location and fixed with sutures.Results The keels were removed after 3 weeks of operation in 20 patients.The keels were removed after 2 weeks of operation because of subcutaneous emphysema in 1 patient.After a follow-up of 6 months,the reformation of the web happened in 1 case,while the remaining 20 patients recovered with normal triangle shaped anterior commissure anatomy and no granulation or scar tissue were formed.Conclusion Our study shows that the use of suspension laryngoscopy CO2 laser combined with the placement of laryngeal stent is successful for the treatment of the vocal cords adhesion.This procedure has the advantages of micro trauma to patients with avoiding laryngofissure,it provides simple effective treatment of vocal cords adhesion.

Novel double-layer Silastic testicular prosthesis with controlled release of testosterone in vitro, and its effects on castrated rats / 亚洲男科学杂志(英文版)

Testicular prostheses have been used to deal with anorchia for nearly 80 years. Here, we evaluated a novel testicular prosthesis that can controllably release hormones to maintain physiological levels of testosterone in vivo for a long time. Silastic testicular prostheses with controlled release of testosterone (STPT) with different dosages of testosterone undecanoate (TU) were prepared and implanted into castrated Sprague-Dawley rats. TU oil was applied by oral administration to a separate group of castrated rats. Castrated untreated and sham-operated groups were used as controls. Serum samples from every group were collected to measure the levels of testosterone (T), follicle-stimulating hormone and luteinizing hormone (LH). Maximum intracavernous penile pressure (ICPmax) was recorded. The prostates and seminal vesicles were weighed and subjected to histology, and a terminal dexynucleotidyl transferase-mediated UTP nick end labeling (TUNEL) assay was used to evaluate apoptosis. Our results revealed that the weights of these tissues and the levels of T and LH showed significant statistical differences in the oral administration and TU replacement groups compared with the castrated group (P < 0.05). Compared with the sham-operated group, the ICPmax, histology and TUNEL staining for apoptosis, showed no significant differences in the hormone replacement groups implanted with medium and high doses of STPT. Our results suggested that this new STPT could release TU stably through its double semi-permeable membranes with excellent biocompatibility. The study provides a new approach for testosterone replacement therapy.

Deformidad facial postraumática asociada a complicación por silastic orbitario 35 años después de implantado / Post-traumatic facial deformity associated with a complication caused by orbital silastic 35 years after implantation

Las alteraciones esqueléticas del macizo facial sin tratamiento quirúrgico o con un manejo inadecuado, pueden resultar en deformidad secundaria importante con implicaciones estéticas y funcionales que deben ser consideradas para su tratamiento. El objetivo de esta presentación fue caracterizar el caso de deformidad facial postraumática asociada a complicación por silastic orbitario, 35 años después de implantado este. Se trata de un paciente masculino de 67 años que refirió haber sido tratado al presentar enrojecimiento de un ojo y secreciones. Refiere que hace 35 años fue intervenido quirúrgicamente por fractura en la zona del ojo izquierdo, que le colocaron silastic, y que no había tenido problemas hasta el momento en esa área. En el examen físico facial se detectó asimetría facial: ligero enoftalmo del ojo izquierdo, con desnivel pupilar, disminución de la apertura palpebral, rasgo antimongoloide, con eritema de la conjuntiva, quémosis, y abundantes secreciones. Se comprobó limitación del movimiento súpero-externo. Se corrobora la presencia de una fístula en el fondo de saco del párpado inferior. Se diagnostica como deformidad facial postraumática complicada por reacción a cuerpo extraño (al silastic). Fue intervenido quirúrgicamente y se realizó la exéresis del material, y la reconstrucción de la antomía ausente en la zona con malla de titanio. Se obtuvo excelentes resultados. Las lesiones postraumáticas de la cara se asocian generalmente con grandes secuelas funcionales y estéticas. Si se añaden las complicaciones por el empleo de implantes de biomateriales, la determinación de la conducta terapéutica puede ser un reto(AU)

Skeletal facial alterations not treated surgically or inappropriately handled may result in considerable secondary deformity with esthetic and functional implications which should be considered for treatment. The purpose of the study was to characterize a case of post-traumatic facial deformity associated with a complication caused by orbital silastic 35 years after implantation. A male 67-year-old patient reported having been treated for redness of one eye and secretion. Thirty-five years before he had been operated on for a fracture in the area of the left eye. Silastic had been implanted and he had not had any problems until now. Physical examination revealed facial asymmetry: slight enophthalmos of the left eye with pupillary unevenness, reduced palpebral opening, antimongoloid feature, conjunctival erythema, chemosis and abundant secretion. Upper-outer movement was limited. A fistula was found in the bottom of the lower palpebral sac. It is diagnosed as post-traumatic facial deformity complicated by reaction to foreign body (silastic). Surgery was performed to remove the material and reconstruct the missing anatomy in the area with titanium mesh. Excellent results were obtained. Post-traumatic facial lesions are generally associated with large functional and esthetic sequelae. When complications are added due to the use of biomaterial implants, determination of the appropriate therapeutic management can be a challenge(AU)

Transantral Orbital Floor Fracture Repair Using a Folded Silastic Tube

OBJECTIVES: The purpose of this study was to evaluate the advantages and limitations of using a silicon tube to support the fractured orbital floor by a transantral approach. METHODS: A retrospective study was conducted from January 2000 to December. 2011 in 51 patients with pure orbital floor fractures. The patients underwent reduction surgery via a transantral approach for inserting a folded silastic tube to support the fractured orbital floor in the maxillary sinus. A chart review of preoperative and postoperative ocular symptoms, operation records, and complications was maintained. RESULTS: In 18 out of 25 patients with diplopia, postoperative improvement was seen. In 13 out of 15 patients with extraocular muscle limitation, postoperative improvement was seen. Enophthalmos resolved postoperatively in four of five patients. Postsurgical complications occurred in three patients: an overcorrection, an infection in the maxillary sinus, and an implant extrusion, all of which were resolved by revision surgeries. CONCLUSION: During the course of the study, we sensed reduction using a folded silastic tube via a transantral approach as an easy and effective technique with good postoperative results, and minimal implant related complications. This novel procedure is recommended as a surgical option for the reduction of orbital floor fractures.

A Case of Successful Endoscopic Dacryocystorhinostomy in Nasolacrimal Duct Obstruction with Wegener Granulomatosis

PURPOSE: To report a case of nasolacrimal duct obstruction occurring in a patient with Wegener granulomatosis treated successfully with endoscopic dacryocystorhinostomy. CASE SUMMARY: A 36-year-old female diagnosed with Wegener's granulomatosis 3 years prior and treated with rituximab and currently taking azathioprine 100 mg presented with a 1-year history of left epiphora and mucus in the left eye. Her left tear meniscus was higher than the right and was a hard stop with lacrimal probe when a lacrimal probing test was performed. Mucus was regurgitated during lacrimal irrigation and middle turbinate was not observed due to granuloma in the nasal cavity. Dacryocystography showed proximal nasolacrimal duct obstruction and a well-defined dacryocystocele 6 x 5 x 6 mm in size was observed on the left lacrimal fossa on facial 3D computed tomography. After synechiolysis for a granuloma in the nasal cavity, endoscopic dacryocystorhinostomy was performed and silastic sheet sutured on the nasal septum to prevent resynechia. After 2 weeks and 4 months, the silastic sheet and silicon tube were removed, respectively. The patient was asymptomatic following surgery and there was no regurgitation during lacrimal irrigation test. The ostium was patent at 5 months after surgery using the endoscopic dye test. CONCLUSIONS: Nasolacrimal duct obstruction occurring in a patient with Wegener's granulomatosis can be treated effectively with endoscopic dacryocystorhinostomy even if the nasal cavity is narrow due to granuloma.

The Effect of Nasal Packing with Rolled Silastic Sheet after Closed Reduction of Nasal Bone Fracture

PURPOSE: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. METHODS: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I(n=92), Merocel(R) was used for nasal packing, for Group II(n=152) vaseline gauze was used, and Rolled silastic sheet(RSS) with vaseline gauze packing(VGP) was used for Group III(n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. RESULTS: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased(p0.05). CONCLUSION: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.

Frequency of Nasal Septal Perforation at the Suture Fixation Site of a Silastic Sheet Inserted during Nasal Surgery

OBJECTIVE: This study was performed to evaluate the frequency of nasal septal perforation at the suture fixation site of a silastic sheet inserted during nasal surgery. METHODS: Seven hundred and twenty-one patients with silastic sheet insertion during common nasal surgeries were examined. The frequency of perforations and subjective symptoms of the patients were evaluated. RESULTS: Nasal septal perforation at the suture fixation site occurred in seven patients (0.97%). In three patients, perforations occurred immediately after removal of the sheet, while four patients developed perforations 2 to 4 weeks later. In most cases, perforations were small and did not exceed 2 to 3 mm in diameter. No patient complained of nasal symptoms related to the septal perforation postoperatively. CONCLUSION: The frequency of the septal perforation at the suture fixation site of a silastic sheet was very low and subjective symptoms were absent.

Chronic Maxillary Sinusitis Occurred after Reconstruction of Inferior Orbital Wall Fracture / 대한이비인후과학회지

A 27-year-old man presented with symptoms of chronic postnasal drip and nasal obstruction, which had begun one year earlier. He had undergone an ophthalmologic operation due to inferior orbital wall fracture 12 years ago. During physical examination, mucopurulent discharge was observed from the right middle meatus. On the paranasal sinus computed tomography, a sheet-like foreign material was observed inside the right maxillary sinus and haziness was found in the right maxillary, ethmoid, and frontal sinuses. Endoscopic sinus surgery was performed and a silastic sheet, which had been inserted during previous surgery, was removed. After surgery, the patient's symptoms disappeared gradually. We report a case of maxillary sinusitis that occurred after orbital wall reconstruction with a silastic sheet and discuss about the efficacy of the silastic implant.

Easy Reproducible Tie-over Dressing using Silastic(R) Drainage

PURPOSE: Tie-over dressing is widely used to secure skin grafting on face, body, or extremities. It can be a rather complicated task and is not easy to make compressive dressing again if performed in a conventional method. So, we hereby introduce an easy reproducible tie over dressing method. METHODS: After completing the skin graft, Cut the silastic drainage longitudinally in half and spread to the grafted skin margin. Drainage is fixed by using the stapes or sutures. A fluffy gauze bolus dressing is placed over a furacin impregnated gauze and wrapped around. After suturing the distal margin of silastics with opposite side using the silk thread either 5-0 or 3-0, knot of suturing, which is pressed down against the dressing while the threads are tightened, is made into center of each sides. RESULTS: It can make dressing again after observing the grafted skin, and it can also make pressure on the grafted area evenly until the grafted skin is taken. CONCLUSION: This dressing method makes the surgeons and patients comfortable. To surgeons, it provides more rapid and easier way to do dressing, and to patients, it eliminates pain caused by redressing.

Comparison of Clinical Efficacy Between Tie Methods of Silicone Tube Intubation in Nasolacrimal Duct Obstruction

PURPOSE: To compare the clinical outcome of silicone tube intubation according to the tie methods. METHODS: Eighty-eight eyes of 87 patients who underwent silicone tube intubation were divided into two groups based on the tie method: a silicone silastic sheet group (Group 1, n=59) and a nylon 6-0 suture knot group (Group 2, n=29). The two groups were compared according to their success rates, recurrence rates and complications. RESULTS: No significant difference was found in the success rate between the two groups (83.0% in Group 1 and 82.7% in Group 2). However, Group 2 showed a significantly higher rate of postoperative complications than Group 1. In Group 1, 5/59 (8.4%) eyes had ocular irritation, 2/59 (3.4%) eyes exhibited tube prolapse, conjunctivitis, corneal erosion, and dacryocystitis and 1/69 (1.6%) eyes had a punctal slit after intubation. In Group 2, 3/29 (10.3%) eyes had ocular irritation, 2/29 (6.9%) eyes exhibited tube prolapse, conjunctivitis, a punctal slit, and dacryocystitis, and 1/29 (3.4%) eyes showed corneal erosion, or a granuloma after intubation. A recurrence of symptomatic tearing was found in 6/59 (10%) eyes in Group 1 and 3/29 (10%) in Group 2. CONCLUSIONS: In silicone tube intubation of incomplete NLD obstruction, the usage of silicone silastic sheets to tie both ends of the silicone tube produced a lower complication rate and a higher success rate than that of the suture knot group. Lower tension on the nasolacrimal passage in the silicone silastic sheet group allows for a significantly lower rate of punctal slit development. Therefore, the method of using silicone silasitic sheets can be considered useful in the treatment of NLD obstruction.

Prevention of Lateral Synechia Formation with Silastic Sheet in the Endoscopic Sinus Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Lateral synechia formation between the middle turbinate and the lateral nasal wall is one of the most common complications in endoscopic sinus surgery. Unstable and floppy middle turbinate occurs not infrequently and it may make meticulous postoperative dressing difficult during healing period, and consequently increases the risk of synechia and recurrence of sinusitis. The aim of this study was to investigate whether insertion of the silastic sheet in the middle meatus can effectively prevent the synechia formation. SUBJECTS AND METHOD: Twenty eight patients (31 sides including 3 bilateral cases) with unstable and floppy middle turbinate occurred during endoscopic sinus surgery were enrolled in this study. The silastic sheet was designed in fan-shape and inserted between the middle turbinate and the lateral nasal wall. The silastic sheet was secured to the caudal septum and removed 2 to 3 weeks after the operation. We performed a follow-up study for 5 months and investigated the occurrence rate of synechia. RESULTS: The success rate of our method was 90.3% and synechia in the middle meatus developed in 3 of 31 sides (9.7%). Although synechia between the middle turbinate and nasal septum occurred in 4 sides, the patients did not complain of olfactory disturbance. CONCLUSION: The results of this study suggest that insertion of the silastic sheet in the middle meatus can be a useful method in the prevention of lateral synechia formation when unstable and floppy middle turbinate has developed during endoscopic sinus surgery.

Effects of self-made carina type tracheal prosthesis on survival period and healing of anastomotic stoma in dogs / 吉林大学学报(医学版)

Objective To investigate the feasibility of using a new type carina type tracheal prosthesis made of complex material to replace trachea and carina defects. Methods According to biomechanics index, a new carina type tracheal prosthesis was designed and constituted with carbon fiber and silicon. 19 dogs were divided into two groups randomly: group A(n=11), the carina type tracheal prosthesis anastomosed directly to dog′s trachea and bronchus;group B(n=8), based on group A, meanwhile the diaphragm was incised and the pedicel caul was transplanted from abdominal cavity to thorax to enwrap the carina type tracheal prosthesis and anastomotic site. Results The average survival period post operation in group A and group B were (3.462?1.849)d and (6.475?1.062)d ,respectively. There was significant difference of the survival period between two groups(P

Repair of Nasal Septal Perforation Using Silastic Sheet / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In general, for surgical treatment of septal perforation, a suture repair method is necessary for at least unilateral intranasal mucosal flap with the interposition of a connective tissue graft. However, autologous graft material is sometimes insufficient when septal perforation repair is combined with other surgery such as rhinoplasty. The aims of this study were to introduce a new repair technique of septal perforation using silastic sheet and to assess the usefulness of the new method. SUBJECTS AND METHOD: Between March 2003 and September 2004, 5 patients underwent septal perforation repair using silastic sheet with open rhinoplasty at the same time. Size and causes of septal perforation, symptoms, and complication were evaluated by endoscopic examination and questionnaires pre- and postoperatively. RESULTS: The causes of septal perforation were previous septoplasty (3 cases), syphilis (1 case) and unknown (1 case). Preoperative symptoms including nasal obstruction, rhinorrhea, epistaxis and dryness were all improved postoperatively. The perforations of all patients were 1.0 cm sized or more in diameter. Four of five patients (80%) achieved complete closure and one patient had an incomplete closure after a mean follow up of 16 months. CONCLUSION: The repair of septal perforation using silastic sheets is a very useful technique when the size of septal perforation is more than 1 cm large in diameter or when the autograft material is insufficient.

A Silastic Sheet found during Endoscopic Transnasal Dacryocystorhinostomy for Acute Dacryocystitis

PURPOSE: To report the case of a silastic sheet that was found during an endoscopic transnasal dacryocystorhinostomy for treatment of acute dacryocystitis with necrosis of the lacrimal sac. METHODS: A thirty-two year old male presented with painful swelling on the nasal side of his left lower lid two weeks prior to visiting this clinic. Fourteen years ago, the patient was involved in a traffic accident and underwent surgery to reconstruct the ethmoidal sinus. Lacrimal sac massage showed a regurgitation of a purulent discharge from the left lower punctum. Therefore, the patient was diagnosed with acute dacryocystitis and an endoscopic transnasal dacryocystostomy was performed the next day. RESULTS: The surgical finding showed severe necrosis around the lacrimal sac and a 20 x 15-mm sized silastic sheet was found crumpled within the purulent discharge. The sheet was removed, the lacrimal sac was irrigated with an antibiotic solution, and a silicone tube was intubated into the lacrimal pathway. After surgery, the painful swelling on the nasal side of left lower lid resolved gradually, and there were no symptomatic complications three months later. CONCLUSIONS: We report the first case where a silastic sheet applied during a facial reconstruction had migrated adjacent to the lacrimal sac resulting in severe inflammation.

A Case of Surgical Treatment of Atrophic Rhinitis: Silastic Implant

The literature does not report a cure for atrophic rhinitis, but considerable relief of symptoms such as foul odor, crust formation and nasal stuffiness could be given to the patient by surgical treatment, which always involves a method of narrowing the nasal airway. In this report, a review of the surgical technique of silastic implantation, clinical results and follow up is presented. Forty three years old female patient who was diagnosed as primary atrophic rhinitis was treated surgically with silastic implantation. The result was excellent with complete resolution of the major symptoms. There was no complication such as extrusion of implant. We found that the silastic is a readily available and inexpensive material and the surgical procedureis relatively simple to perform and easily revised. We propose silastic implant as a treatment modality of atrophic rhinitis with a review of literatures.

Clip Reinforcement Technique by Circumferential Wrapping with Silastic Sheet for Treatment of Cerebral Aneurysms and Its Follow-Up Outcome / 대한뇌혈관외과학회지

OBJECTIVE: To describe the clip reinforcement technique by circumferential wrapping with silastic sheet for the treatment of unclippable cerebral aneurysms and evaluate its long term follow-up results. METHODS: The nature of 26 unclippable aneurysms were as follow:12 blister-like superior wall aneurysm of internal carotid artery (ICA), 6 microaneurysms (<2 mm), 4 fusiform aneurysms, 4 broad-based aneurysms. After aneurysm and the parent artery are circumferentially wrapped by silastic sheet, aneurysm clips are positioned on the sheet with parallel to the parent artery. The mean follow-up period was 37 months (range, 3-140 months). RESULTS: 25 of 26 patients had a favorable outcome and one patient had a severe disabled due to severe vasospasm at 3 months after operation. Of the 21 patients who underwent immediate angiographic examination, stenosis of parent artery was detected in 6 patients and remnant of aneurysm in 4 patients. Asymptomatic occlusion of parent artery was observed in one patient on follow-up angiographic examination. 22 of 24 patients followed-up for a long time had a favorable outcome and 2 patients had a severe disabled (one patient was due to previous severe disabled and the other was due to thalamic intracerebral hematoma developed during the follow-up period). CONCLUSION: In our study, there was no clip reinforcement technique-related clinical complications such as rebleeding of aneurysm or ischemic event during follow-up period. Clip reinforcement technique by circumferential wrapping with silastic sheet is simple and useful method for the unclippable cerebral aneurysm.

Repair of large area of tracheal wall defects with silastic framework:an experimental study / 中华创伤杂志

Objective To explore the feasibility of artificial silastic framework(SF)in repair of large area of tracheal wall defects.Methods Twenty healthy adult dogs with tracheal defects for 2.5 cm?6.0 cm-3.0 cm?6.0cm were randomly and equally divided into experimental group(repaired with SF combined with sternohyoid fasciae)and control group(repaired with T-silastie tubule combined with sternohyoid fascial flap).After the operation,the animals were sacrificed at the 4th,8th,16th,24th, and 48th weeks respectively for harvesting the tracheae that were used for tracbeoscopically observing in- flammatory reaction of the repaired defect area and light microscopically observing epithelium healing on the repaired defect area.Results In the experiment group,the repaired trachea was smooth,without proliferation of granulation;and at the 8th week,the repaired defect area was covered with epithelial cells,with good functional recovery of respiration,phonation and deglutition.In the control group,there was obvious proliferation of granulation on the tracheal surface near anterior and posterior ends of T-silas tic tubule.The animals were under asphyxia to die with extraction of T-silastic tubule.Conclusions SF has excellent tracheal skeletal function.In the meantime,SF combined with sternohyoid fasciae is a simple but effective method for repair of large area of tracheal wall defects.