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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a classic article published in 1949 Marshall, Marchetti, and Krantz demonstrated that stress incontinence in women without uterine prolapse could be corrected by a simple vesicourethral suspension. Beginning in 1960 one of the authors (W.E.C.) became concerned about suturing the urethra to the periosteum of the pubis. It occurred to him that use of the upper sutures only to pull up the bladder and hold its anterior wall to the back of the rectus muscles might be just as effective, and this has proved to be so.
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PMID:Modification of Marshall-Marchetti-Krantz operation. 70 23

Orbital trauma may result in what we term "pseudoprolapse" of orbital tissues: a subperiosteal, submucosal, or intramucosal hemorrhage which creates a balloon-like elevation of periosteum or maxillary sinus mucosa or both associated with a nondisplaced fracture or in some cases no fracture of the orbital floor. This occasionally causes an erroneous radiographic diagnosis indicating a blowout fracture with prolapse of orbital tissues, resulting in unnecessary surgery.
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PMID:Traumatic "pseudoprolapse" of orbital tissues into the maxillary antrum: a diagnostic pitfall. 120 26

Some of the patients requesting blepharoplasty have a combination of excessive eyelid fat and brow ptosis but little or no dermatochalasis. Coronal brow lift, combined with transcoronal fat removal, serves these patients well. The prelevator fat pocket is easily entered from above by incising the periosteum of the anterior orbital roof just inside the orbital rim. Since the orbital septum and anterior lamella of the eyelid rim remain undisturbed, the result appears natural. Contraindications to the procedure include significant medical pocket fat and hair patterns that would exclude a coronal or hairline incision. Two complications, unilateral ptosis and unilateral chemosis, were temporary and totally reversible. Minor changes in the procedure have prevented the recurrence of these problems.
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PMID:Transcoronal blepharoplasty. 141 34

The authors present a new technique of face lift via a temporal approach which allows them to perform a "Total SMAS Lift" of the supra- and infra-zygomatic region. They use the passage on the deep side of the superficial layer of the temporal fascia, which avoids damage to the frontal branch of the facial nerve. Undermining of the periorbital area is performed under the muscle, but above the periosteum of the malar bone. This technique is situated between the subcutaneous face lift and the superiostal mask-lift. This technique can also be combined with a frontal or cervico-facial lift. This "Total SMAS Lift" is essentially indicated in patients with early ptosis of the cheek, the peri-orbital area ant the naso-labial folds and the aesthetic results are gratifying.
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PMID:["Total SMAS lift" or deep facial lift by temporal approach. Initial report]. 152 96

A new surgical technique is described for the relief of the ocular manifestations of dysthyroid orbitopathy. Surgical decompression of the orbit was reserved for patients who failed to respond to medical treatment. Eleven patients (nine women and two men) were followed for periods from 3 to 48 months. Visual loss was the commonest presentation and the main indication for surgery. All patients had failed to respond to medical therapy, consisting of steroid and/or radiation therapy. Three patients had previously undergone orbital decompressions with limited success. Six patients had preoperative visual acuity of worse than 20/200. Preoperative exophthalmos ranged from 24 to 35 mm (normal 16 mm). The orbits were approached by a bifrontal scalp flap with exposure of the temporal and infratemporal fossae. The orbital roof was approached transcranially. The posterior wall of the frontal sinus was removed together with the mucous lining. To maximize the decompression, the periosteum surrounding the orbital contents was incised, allowing the contents to prolapse through the newly created windows into the maxillary antrum, temporal fossa, anterior cranial fossa, and nose. During the past 3 years, 22 orbits in 11 patients have been decompressed by this technique. Symptomatic relief was obtained in all but one patient who still had significant exophthalmos with keratitis, but did have a dramatic improvement in vision. The decrease in exophthalmos ranged from 1 to 13 mm (mean 7 mm). The most dramatic improvement was in vision, with postoperative acuity of 20/20 to 20/30 in all but two patients. There were no deaths and no major morbidity.
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PMID:A four-wall orbital decompression for dysthyroid orbitopathy. 335 28

Twenty seven frontalis sling procedures were performed with use of autogenous fascia-lata. The choice of this procedure was performed sometimes at the first stage for severe ptosis with poor levator function: isolated congenital ptosis, blepharophimosis syndrome, Marcus Gunn Jaw-Winking ptosis, ptosis with severe myopathy, some traumatic ptosis. This procedure was also performed in a second stage after failure of the useful procedures (levator resection) and after verification that the levator was not exploitable. Sometimes the choice of the procedure is done during the exploration of the eyelid and the levator because there is not always "parallelism" between the levator function and his anatomy. So operative technique must always be performed by a complete anterior palpebral approach, the surgeon can passed the suspensory material from the tarsus to the roof of the orbit, just anterior to the levator aponeurosis, and then out above the eyebrow. The pulley this created by the periosteum of the superior orbital margin prevents vertical traction lines. The skin crease is created with sutures which pick up the tarsus and the lid retractors. If, during the explorations the levator is "exploitable", a super maximum levator resection will be performed at the first stage, the frontalis suspension will be maintained in case of failure of the levator resection.
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PMID:[Suspension of the eyelid to the frontal muscle in the surgery of ptosis. Technic and indications]. 380 95

Patients with chronic forms of blepharochalasis often develop eyelid deformities characterized by blepharoptosis and prolapse of the orbital fat and lacrimal gland. Some individuals have an acquired form of blepharophimosis, secondary to the dehiscence of the canthal tendons. In this late stage of the condition, the tendons still adhere to the periosteum of the orbital rims and loss of fixation occurs at the distal attachment between the tendons and the eyelid tissues. This results in a horizontally shortened palpebral fissure and a rounded deformity of the lateral canthal angle. Surgery remains the primary treatment.
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PMID:Blepharochalasis syndrome. 398 80

Twenty-two patients were operated upon for posthysterectomy vaginal prolapse. The original operation had been abdominal hysterectomy in 11 patients and vaginal hysterectomy in an additional 11 patients. All of the corrective operations were performed abdominally. Vaginal sacropexy was performed upon eight patients with our own modified method using a fascial strip taken from the rectum sheath. Dexon sutures were used in the attachment of the strip to the apex of the vagina and to the periosteum of the sacrum. The fascial strip was peritonealized. A high resection of the enterocele sac was performed. Excellent permanent vaginal support was achieved in all of these patients. Other methods of operation used included direct fixation of the vaginal apex to the presacral fascia, fixation of the vagina with round ligaments and the method according to Williams and Richardson. More than one-half of the patients had recurrences.
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PMID:Prolapse of the vagina after hysterectomy. 401 48

Forehead-brow rhytidoplasty has evolved from a procedure primarily advocated for brow ptosis, to one in which a group of deformities are routinely addressed. It has also become evident that the surgical results stem from wide undermining with release of the periosteum and the concomitant alteration of the forehead muscles and not necessarily from skin lifting using elevation/excision ratios. Therefore, with the introduction of endoscopically assisted techniques to plastic surgery, the indications for a long forehead incision and its untoward sequelae have to be reconsidered. The anatomic basis for minimally invasive forehead-brow rhytidoplasty and three types of procedures are discussed. These include Type I--complete, endoscopically assisted forehead-brow rhytidoplasty; Type II--segmental, in conjunction with facelift surgery; and Type III--isolated, frown-muscle modification. The role of fixation (external support, internal suspension, or excision techniques) is described. Results suggest that these options provide a worthwhile alternative to traditional "open" techniques in certain circumstances, although some relevant questions remain unresolved.
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PMID:Endoscopically assisted forehead-brow rhytidoplasty: theory and practice. 759 25

Although significant innovations in brachioplasty occurred in the 1970s, it remains an unpopular procedure. Current brachioplasty techniques are somewhat unpredictable and are commonly associated with significant untoward results. Recent anatomic studies demonstrate that in youth the posteromedial arm soft tissues are firmly suspended to a tough yet dynamic fascial system sling that ultimately gains its strength from the clavicular periosteum by means of the clavipectoral and axillary fasciae. Loosening of the connections of the arm superficial fascial system to the axillary fascia, as well as relaxation of the axillary fascia itself, with age, weight fluctuations, and gravitational pull yields a "loose hammock" effect, resulting in significant ptosis of the posteromedial arm. On the basis of this anatomic concept, the brachioplasty procedure was modified to provide secure anchoring of the arm flap to the axillary fascia along with strong superficial fascial system repair of incisions, reducing the risk of widening or migration of scars and unnatural contours. Five patients having brachioplasty with or without liposuction were followed for 6 to 12 months. The primary indication for surgery is moderate to severe skin laxity of the arms with or without associated arm fat deposits. Results were consistent, and complications were limited.
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PMID:Brachioplasty with superficial fascial system suspension. 765 66


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