Nasomaxillary fracture is a characteristic mid-facial fracture, and there are no reports showing the fracture damaging the nasolacrimal system (NLS). This report described nasomaxillary fracture cases with NLS damages, which were assessed by computed tomographic dacryocystography (CT-DCG). A retrospective cohort study of nasomaxillary fractures diagnosed by CT was conducted from 2007 to 2015. Twelve patients (mean age: 27.5 years) were found, and their clinical symptoms were as follows: nasal deformity in 10 patients, infra-orbital hypoesthesia in 7, epiphora in 5, and diplopia in one. CT-DCG was performed for 2 patients who complained epiphora, and obstruction was found in 1 patient. All patients underwent open reduction and internal fixation (ORIF), and epiphora in 5 patients was improved. One patient, however, complained epiphora postoperatively, which was supposed to be due to the unsuitable screw insertion. Since nasomaxillary fracture could give NLS obstruction, CT-DCG is useful for diagnosis. Although ORIF is an optimal treatment, attention is needed to avoid the lacrimal canal in screwing on the nasomaxillary buttress.
要 旨2010 年 1 月から 2016 年 9 月までの期間に,東京女子医科大学東医療センター形成外科でレーザー治療が終了した 生後 1 カ月から 42 カ月までの乳児血管腫 152 症例(男児 34 例,女児 118 例)を対象とした.今回,レーザー治療を 行った症例について,特に合併症の有無に関して統計学的検討を行い,レーザー治療の合併症の発症因子は,乳児血 管腫の面積が 4 cm 2 以上,照射回数 6 回以上,未熟児の 3 項目に有意差を認めた.
キーワード:乳児血管腫,レーザー治療,多変量解析
AbstractWe enrolled 152 infants aged 1 to 42 months old with infantile hemangioma by laser treatment in Tokyo Women's Medical University Medical Center East Plastic surgery from January 2011 to September 2016. This time, we investigate complication of infantile hemangioma by laser treatment. The risk factor of it is concerned to be infantile hemangioma area ≥4 cm 2 , number of times ≥6, premature baby.
In this paper, we give a purely algebraic proof of an identity coming directly from Euler's reflection formula for the gamma function. Our proof uses Hoffman's harmonic algebra and some binomial identities.
Distal digital replantation is frequently associated with arterial thrombosis and/or spasm, leading ischemia in the replanted tissue. This report introduced a rescue technique for ischemia after distal digital replantation without reanastomosis. Two males, 64 and 51 years old, underwent Ishikawa subzone II finger amputations. Microsurgical replantations with vein grafts were performed. Intraoperatively, heparin and urokinase through intra-arterial infusion were given for one week. At 40 to 48 hours after surgeries, the replanted digits developed ischemia; massaging digital arteries at the proximal phalanx regions with running warm water was immediately initiated and ischemia was improved. In both cases, the replanted tissues were rescued, though a partial necrosis requiring full-thickness skin grafting was found in one case. This massage was easily, safely, and effectively performed without complications and was applicable in cases with ischemia after distal digital replantation, especially where reanastomosis was unfeasible.
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