ABSTRACT
OBJECTIVES/HYPOTHESIS: The objective was to determine the time interval after brow lift required to achieve periosteal readhesion to the skull with preoperative strength [corrected]. STUDY DESIGN: Randomized prospective analysis of variance with repeated measures. METHODS: Twenty-one New Zealand white rabbits, each serving as its own control, underwent subperiosteal elevation on one side of the skull. The elevated periosteum was lifted and fixed to a resorbable screw, and the contralateral periosteum was left untouched. Adhesion characteristics were subsequently examined at postoperative days 5, 6, 7, 8, 10, 12, and 17. Seven subjects were assessed histologically to determine attachment of periosteum to underlying bone. Fourteen subjects underwent biomechanical analysis of the bone-periosteum interface using the following three measures of periosteal readhesion strength: ultimate shear strength, shear stiffness, and shear energy [corrected]. RESULTS: Blinded histological analysis showed a qualitative increase in the number of markers of periosteal healing on days 8 to 12 for the operated sides. Analysis of ultimate shear strength and shear stiffness demonstrated a significant relationship to postoperative day (P <.001). The ultimate shear strength and shear stiffness of the operated side approached that of the nonoperated side by postoperative days 12 and 8, respectively. Shear energy was significantly lower for all time points on the operated side as compared with the control (P <.02). CONCLUSION: Periosteal readhesion after surgical elevation approaches preoperative strength by the twelfth postoperative day.
Subject(s)
Forehead/surgery , Rhytidoplasty , Absorbable Implants , Animals , Biomechanical Phenomena , Bone Screws , Endoscopy , Periosteum/surgery , Rabbits , Rhytidoplasty/methods , Skull , Stress, Mechanical , Tensile Strength , Time Factors , Tissue Adhesions , Wound Healing/physiologyABSTRACT
Facial nerve schwannomas are clinically challenging tumors. This is a case study of a young woman with an extensive facial nerve schwannoma. The clinical presentation, radiographic diagnosis, pathological confirmation, and treatment options for this relatively rare tumor are discussed.
Subject(s)
Facial Nerve Diseases/diagnosis , Neuroma, Acoustic/diagnosis , Adult , Audiometry , Biopsy , Facial Nerve Diseases/complications , Facial Nerve Diseases/surgery , Facial Paralysis/classification , Facial Paralysis/etiology , Female , Hearing Loss, Conductive/etiology , Humans , Magnetic Resonance Imaging , Neuroma, Acoustic/complications , Neuroma, Acoustic/surgery , Otitis/etiology , Patient Selection , Recurrence , Severity of Illness Index , Tinnitus/etiology , Tomography, X-Ray ComputedABSTRACT
Acute otitis externa is a common presenting disorder seen in many primary care offices. Serious complications may be avoided by appropriate diagnosis and treatment. This article will summarize the basic anatomy and physiology of the external auditory canal, the pathophysiology and microbiology of acute otitis externa, the clinical presentation and diagnosis of this disease, and its potential complications and treatment.
Subject(s)
Otitis Externa , Acute Disease , Ear, External/anatomy & histology , Ear, External/physiology , Humans , Otitis Externa/diagnosis , Otitis Externa/drug therapy , Otitis Externa/microbiology , Otitis Externa/physiopathology , Otitis Externa/prevention & controlABSTRACT
Benign paroxysmal positional vertigo is a disorder of the peripheral vestibular system characterized by brief episodes of vertigo precipitated by head movements in certain planes. It is one of the most common causes of vertigo. Displaced otolithic debris in the posterior semicircular canal is the proposed mechanism of this disorder and explains the success of repositioning procedures in treating these patients. The pathophysiology, diagnosis, and treatment options are discussed.
