ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04132.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04133.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

More ophthalmic surgeons should be encouraged to use the operating microscope, one of the most important and spectacular advances in surgery in this century. Its advantages are established. This paper discusses practical recommendations based on observations made from a decade of personal experience and from the problems encountered by students at microsurgical courses. The recommendations are as follows: (i) Instrumentation. Surgeons must understand the structure and limitations of the microscopes and the microinstruments; (ii) Inherent disadvantages. There are several disadvantages inherent in performing surgery under the operating microscope, e.g., the ophthalmic surgeon becomes “immobile”, and the operating field of vision is narrow. All these disadvantages require adjustment. With an understanding of these problems, more surgeons will eventually be able to overcome the difficult

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04134.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Barraquer was the first ophthalmic surgeon who consistently took into account modern technology when planning the details of his operating theatre. Since then, ceiling suspension of a microsurgical unit, with remote control for all functions in ophthalmic surgery, has been taken for granted. During the recent decade the microscopes and instruments used have been remarkably improved. This is true for the microscope itself and its accessories, but even more so for many of our remote‐controlled instruments, such as rotortrephines for perforating grafts, rotorkeratomes and rotorknives, and recently for the new automatic lamellarkeratom. Better cutting quality leads to more precise wound edges, to better coaptation, and to better optical results. These systems also can be useful in cataract surgery, especially in the implantation of new intraocular lense

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04135.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

The authors describe the microsurgical technique applied for the primary and secondary reconstruction of destroyed lacrimal canaliculi. In the event of fresh injuries, they recommend the immediate repair of the mucosal tissue and the reconstruction of the muscle tissue after direct or retrograde intubation of the lumina canaliculi. For secondary reopening of a stenosis, depending on the localization and the extent of the injury, various methods can be used, such as retrograde probing, the opening of the canaliculus in the area of the punctum papilla as described by Ark, retrograde opening from the tear sac in the manner used by Sattler or from the canaliculus communis following the method of Busse and colleagues. In the event that a substitute is necessary, then the authors recommend the implantation of a hydrophilic tear duct prosthesis in combination with a conjunctivodacryocystostomy in the manner described by Stallard.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04136.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Five areas of active clinical research development in otolaryngology have been selected to illustrate the specific applications of microsurgical principles and the potential future of associated bioengineering research. These are: (i) biocompatible microelectronic circuitry and cochlear electrode implant in total cochlear deafness, with preservation of auditory nerve function; (ii) microneural surgery of the facial nerve in hemifacial spasm and the techniques available for reinnervation of the paralysed larynx; (iii) laser microsurgery of the larynx — a new surgical modality dependent on high‐precision control through the operating microscope; (iv) microvascular free tissue transfer in head and neck reconstruction and its potential value following combined irradiation therapy for carcinoma; and (v) human laryngeal transplantation — its current s

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04137.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Tympani neurectomy with or without chorda tympani section is a surgical procedure which can play a role in the treatment of diseases for which more extensive procedures have in the past been performed. The surgical approach is familiar to most ear, nose and throat surgeons, and the operation, which can be satisfactorily performed under local anaesthesia, is associated with very

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04138.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

The transmission of sound to the internal ear passes across the tympanic membrane to vibrate the ossicle chain formed by the malleus, incus and stapes. Movements of the stapes footplate set up complex wave formation within the cochlear fluids to excite the sensory nerve endings of the organ of Corti. Microsurgery for the relief of middle ear deafness has been progressively developed since 1946 and is concerned with the restoration of this collection of sound by an intact flexible ear drum and transmission of oscillation across the middle ear by a free, mobile chain of ossicles. Otosclerosis is a deafness of genetic origin caused by bony overgrowth immobilizing the stapes footplate and is treated with a 95% success rate by selective stapedectomy and fenestration of the footplate. A prosthesis or one limb of the stapes is attached on to the incus and inserted into the fenestration, often with the use of using a tissue graft as a sealing membrane. Over twenty years' experience has originated many differing contours and materials for the stapes prosthesis — in scale some 4 mm or 5 mm in length and 0.3 mm to 0.8 mm in diameter — which will be illustrated and discussed. These prostheses lie deep within a healthy tympanic cavity, and it is most exceptional for a prosthesis to detach or extrude. In our large series subsequent reexploration usually reveals a prosthesis sheathed in mucosa without visible foreign body react

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04139.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Stapedectomy is not an innocuous procedure even under ideal conditions in otosclerosis. In Congenital anomalies it may be hazardous. Victor Goodhill, 1979. Hearing improvement is poor, meatuses tend to stenose and frequently become wet and infected with the final answer still being awaited. Lund and Phelps, 1978.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04140.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

A series of 124 total laryngectomies for carcinoma is reviewed. The postoperative morbidity is discussed, and pharyngocutaneous fistula was found to occur in 30 patients. Its management is reviewed, and consideration is given to its relation to preoperative irradiation. This was found to increase its incidence and adversely affect the prospects of successful closure.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04141.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY