Recurrence Of Exposure Research Articles

Correction of orbital implant exposure using a supra-brow island flap pedicled with orbicularis oculi muscle.

To describe our experience of the supra-brow island flap pedicled with orbicularis oculi muscle technique for correcting orbit implant exposure. This retrospective study reviewed 32 patients that underwent orbit implant exposure surgery using a supra-brow island flap pedicled with orbicularis oculi muscle. All data were reviewed from patients in Eye & ENT Hospital of Fudan University, Shanghai during January 2018 to July 2020. The patient demographics, the original etiology, surgical procedures, implant types, and follow-up interval were recorded. The primary outcome was the long-term coverage of the supra-brow island flap pedicled with orbicularis oculi muscle, and the post-surgical complications and management were secondary outcomes. 28 eyes of 28 patients had functional results and satisfactory cosmetic outcomes at final follow up(range, 9-29 months). Among the other 4 patients, the recurrence of exposure was recorded during the follow-up, two of these patients successfully underwent dermis fat grafts(DFGs), one recovered after conservative treatment, and one refused treatment. The supra-brow island flap pedicled with orbicularis oculi muscle is a technique available to manage orbital implant exposure when other simpler and more direct techniques have been tried and failed. A new flap for orbital implant exposure.

Management of Exposure of Cardiac Pacemaker Systems

The erosion and exposure of pacemakers are relatively uncommon occurrences but, given the number of these devices inserted yearly, they are nevertheless occurrences that plastic surgeons are likely to encounter in practice. Although there is a general agreement that clinically infected devices are best removed, it has been established that exposed but noninfected devices can usually be managed conservatively with coverage procedures. Reports in the literature, to date, describe a number of different procedures for coverage, and these reports generally comprise small numbers of patients. This study describes 16 patients referred to a single surgeon over a 14-year period with exposure or suspected impending exposure of their cardiac pacemaker systems. Fourteen patients required surgical revision for coverage of either the generator or defunctionalized wires. Equivalent success was achieved with either subfascial or submuscular coverage in 11 patients with generators present. Three patients with exposure of defunctionalized wires achieved successful coverage with submuscular burial. There was no correlation of culture results with recurrence of exposure.

A threatened beluga (Delphinapterus leucas) population in the traffic lane: Vessel-generated noise characteristics of the Saguenay-St. Lawrence Marine Park, Canada

The threatened resident beluga population of the St. Lawrence Estuary shares the Saguenay-St. Lawrence Marine Park with significant anthropogenic noise sources, including marine commercial traffic and a well-established, vessel-based whale-watching industry. Frequency-dependent (FD) weighting was used to approximate beluga hearing sensitivity to determine how noise exposure varied in time and space at six sites of high beluga summer residency. The relative contribution of each source to acoustic habitat degradation was estimated by measuring noise levels throughout the summer and noise signatures of typical vessel classes with respect to traffic volume and sound propagation characteristics. Rigid-hulled inflatable boats were the dominant noise source with respect to estimated beluga hearing sensitivity in the studied habitats due to their high occurrence and proximity, high correlation with site-specific FD-weighted sound levels, and the dominance of mid-frequencies (0.3-23 kHz) in their noise signatures. Median C-weighted sound pressure level (SPL(RMS)) had a range of 19 dB re 1 μPa between the noisiest and quietest sites. Broadband SPL(RMS) exceeded 120 dB re 1 μPa 8-32% of the time depending on the site. Impacts of these noise levels on St. Lawrence beluga will depend on exposure recurrence and individual responsiveness.

Pericranium Grafts for Exposed Orbital Implants

To report the use of autologous pericranium grafts to cover exposed orbital implants. A two-center consecutive case series of exposed orbital implants covered with autologous pericranium grafts. A patch of pericranium was harvested from the parieto-occipital region and was placed over the implant within a pocket between the implant and the Tenon capsule, followed by layered closure of Tenon and conjunctiva. Four patients (2 women, 2 men) with a mean age of 37 years (range, 26 to 45 years) were included in the study. The mean follow-up period was 9.5 months (range, 7 to 12 months). In all cases, there was no recurrence of exposure and no donor site morbidity. A small pyogenic granuloma, arising from the conjunctival suture line, developed in one case. Autologous pericranium is a useful covering material for exposed orbital implants and may be used as an alternative to frontal periosteum.