• Title/Summary/Keyword: Aponeurosis

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Strategies of upper blepharoplasty in aging patients with involutional ptosis

  • Lee, Tae-Yul;Shin, Yong Ho;Lee, Jin Gyu
    • Archives of Plastic Surgery
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    • v.47 no.4
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    • pp.290-296
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    • 2020
  • In many aging individuals, dermatochalasis and involutional ptosis appear together. Therefore, for functional and aesthetic purposes, ptosis correction and upper blepharoplasty are performed together. The aim of this article is to investigate factors that should be considered in order to achieve good results when simultaneously performing involutional ptosis correction and upper blepharoplasty in aging patients. Involutional ptosis is usually corrected through aponeurosis advancement in mild cases. In moderate or severe ptosis, the Muller muscle and aponeurosis are used together to correct ptosis. Using the two muscles together has the advantages of reducing lagophthalmos and increasing the predictability of outcomes after surgery. Broadly speaking, the surgical method used for involutional ptosis varies depending on the specific case, but unlike congenital ptosis, it is often not necessary to perform overcorrection. In particular, if there are problems such as severe dry-eye symptoms or risk of lagophthalmos, undercorrection should be considered. When performing ptosis correction, the surgeon should be careful not to overdo skin excision; instead, limited excision should be performed. After ptosis surgery, the brow may descend and the double fold may look too small. However, in order to make the double eyelids look larger, the surgeon should consider making the double eyelid design high rather than excising an excessive amount of skin. In some cases, to obtain more natural double eyelids and favorable results, it may be necessary to perform a sub-brow lift or forehead lift before or after involutional ptosis surgery.

Compression Neuropathy (압박성 신경병증)

  • Kim, Byung-Sung
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.128-133
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    • 2008
  • Nerve compression is caused by external force or internal pathology, which symptom develops along nerve distribution. There are median, ulnar and radial nerve compression neuropathies below elbow. Carpal tunnel syndrome at the flexor retinaculum is most common among all the entrapment neuropathies. Other causes of median nerve neuropathy include Struther's ligament, biceps aponeurosis, pronator teres, FDS aponeurosis and aberrant muscles, which induce pronator syndrome or anterior interosseous nerve syndrome. Ulnar nerve can be compressed at the elbow by arcade of Struther, medial epicondylar groove, FCU two heads, which develops cubital tunnel syndrome, at the wrist by ganglion, fracture of hamate hook and vascular problem, which develops Guyon's canal syndrome. Radial tunnel syndrome is caused by supinator muscle, which compresses its deep branch. Treatment is conservative at initial stage like NSAID, night splint or steroid injection. If symptom persists, operative treatment should be considered after electrodiagnostic or imaging studies.

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Soft Tissue Reconstruction Using Anterolateral Thigh Flap with Fascia Lata Component (대퇴 근막이 포함된 전외측대퇴피판을 이용한 다양한 연부조직 결손의 재건)

  • Lee, Sin-Chul;Eun, Seok-Chan;Baek, Rong-Min
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.655-662
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    • 2011
  • Purpose: The anterolateral thigh flap is versatile flap for soft-tissue reconstruction for defects located at various sites of the body. This useful flap offers a thick and vascular fascia lata component with large amounts that can be soft tissue coverage for different reconstructive purposes. We present our clinical experience with the use of vascular fascia lata, combined with anterolateral thigh flap for various reconstructive goals. Methods: From April 2008 to February 2011, we transferred anterolateral thigh flaps with fascia lata component to reconstruct soft-tissue defects for different purposes in 11 patients. The fascia lata component of the flap was used for tendon gliding surface in hand/forearm reconstruction in 4 patients, for reconstruction medial and lateral patellar synovial membrane and retinaculum in 2 patients, for reconstruction of plantar aponeurosis in the foot in 2 patients, for reconstruction of fascial and peritoneal defect in the abdominal wall in 2 patient, and for dural defect reconstruction in the scalp in the remaining one. Results: Complete loss of the flap was not seen in all cases. Partial flap necrosis occurred in 2 patients. These complications were treated successfully with minimal surgical debridement and dressing. Infection occurred in 1 patient. In this case, intravenous antibiotics treatment was effective. Conclusion: Anterolateral thigh flap has thick vascular fascia with large amounts. This fascial component of the flap is useful for different reconstructive aims, such as for tendon, ligament, aponeurosis defects, abdominal wall or dura reconstruction. It should be considerated as an important advantage of the flap, together with other well-known advantages.

Technique Tip: Percutaneous Gastrocnemius Aponeurosis Recession - A Modified Minimal Invasive Technique (수술 술기: 변경된 비침습적 경피적인 비복근 근막 절제술)

  • Kim, Tae-Hun;Han, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.1
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    • pp.47-50
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    • 2011
  • Equinus contracture of the gastrocnemius-soleus complex is associated with many foot and ankle diseases. We introduce a new simple technique that can be performed using a minimal incision with simple devices. Briefly, 0.5 cm sized medial and lateral longitudinal skin incisions are made at the level of the distal one third of the calf. The musculotendinous junction of the gastrocnemius is gently transected using an Arachnoid blade. The skin is, then, closed with non-absorbable sutures.

Myositis Ossificans Progressiva localized on hands and feet with slow progression - One case report - (수족부에 국한되어 완만한 임상경과를 보이는 진행성 골화성 근염 - 1예 보고 -)

  • Kim, Jae-Hwa;Cho, Duck-Yun;Yoon, Hyung-Ku;Han, Soo-Hong;Kim, Dong-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.247-250
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    • 2002
  • Myositis ossificans progressiva, otherwise called fibrodysplasia ossificans progressiva is a rare hereditary disease of unknown etiology, which is characterized by progressive ectopic ossification in connective tissues of the muscles, tendons, fascia and aponeurosis. We report a case of myositis ossificans progressiva confined to hands and feet, which has an unusual clinical feature with slow progression.

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Diagnostic imaging features of traumatic subgaleal hematoma in a dog: a case report

  • Juyeong Kim;Changhui Han;Youngwon Lee;Hojung Choi
    • Korean Journal of Veterinary Research
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    • v.64 no.1
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    • pp.6.1-6.5
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    • 2024
  • Subgaleal hematomas are accumulation of blood between periosteum and galea aponeurosis. A 2-year-old male Chihuahua was presented with a severe head swelling after trauma. Radiography and computed tomography (CT) showed a massive swelling encircling the entire calvarial vault, extending toward the cervical neck and crossing the suture line. It was heterogeneously, mild hyperdense fluid to soft tissue attenuating with contrast enhancement on CT images. On day 4, physical and imaging examination showed resolution of the calvarial swelling. Subgaleal hematoma should be considered as a differential diagnosis when there is a massive soft tissue swelling over the skull on physical and imaging examinations.

Treatment of Eyelid Ptosis due to Kearns-Sayre Syndrome Using Frontalis Suspension

  • Weitgasser, Laurenz;Wechselberger, Gottfried;Ensat, Florian;Kaplan, Rene;Hladik, Michaela
    • Archives of Plastic Surgery
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    • v.42 no.2
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    • pp.214-217
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    • 2015
  • Blepharoptosis is a common indication for surgery in plastic surgery units, yet its possible underlying pathology frequently remains unidentified. A 52-year-old man with a 20-year history of progressive bilateral ptosis (right>left) presented with recurrent ptosis of both eyes; he had undergone an operation on the levator aponeurosis 12 years prior. Due to the suspicion of an underlying disease, he was evaluated further. Chronic progressive external ophthalmoplegia in transition to the more severe syndromic variant Kearns-Sayre syndrome, a mitochondrial disorder causing myopathy, was diagnosed. The patient was treated with coenzyme Q10, and he underwent ptosis surgery on both eyes. This case illustrates a potentially multi-systemic disease that was diagnosed by a further evaluation of a common symptom, in this case worsening blepharoptosis. Awareness of myopathic symptoms is necessary to prevent overlooking serious yet improvable conditions.

Unusual Presentation of Traumatic Neuroma of the Medial Plantar Nerve after Deep Laceration Mimicking a Foreign Body Granuloma: A Case Report (이물 육아종으로 오인된 심부 열상 이후 발생한 비정상적인 내측 족저 신경의 외상성 신경종: 증례 보고)

  • Woo, Seung Hun;Kim, Tae Woo;Bae, Jung Yun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.174-178
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    • 2017
  • Traumatic neuromas are rare benign tumors that are common after trauma or surgery and are usually accompanied by obvious symptoms of pain. Most reports show neuromas in the face, neck, and limbs, and the traumatic neuroma of the medial plantar nerve has rarely been reported. We encountered a traumatic neuroma of the medial plantar nerve after a deep laceration mimicking a foreign body granuloma. A small mass lesion was found around plantar aponeurosis with heterogeneous high signal intensity in the T2 fat suppression view and slightly enhanced intensity in the magnetic resonance imaging that suggested a foreign body granuloma. The lesion was diagnosed pathologically as a traumatic neuroma. A satisfactory clinical result was obtained after excision of the traumatic neuroma and burial of the proximal and distal stumps to the adjacent muscle at the secondary operation.