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Levator muscle

Hemant K Mehta
The purpose is to present a new refined surgical technique for mild-to-severe acquired myogenic ptosis correction under local anaesthesia (LA) as day cases with resection of myotarsal (MT) flap and demonstrate the safety and efficacy of the technique. MT flap consists of 2 mm tarsal strip with attached levator complex - levator muscle, its aponeurosis, and Müller muscle. This is a retrospective personal series of 400+ patients, who underwent surgical correction with MT flap resection of 8-24 mm under LA mostly as day cases...
March 15, 2018: Orbit
Orhan Beger, Uğur Dinç, Burhan Beger, Deniz Uzmansel, Zeliha Kurtoğlu
PURPOSE: The main objective of this study is to showcase the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor algebraically, to help plan surgeries on newborns and young infants. METHODS: Twenty-five formalin-fixed fetuses (11 male-14 female) with a mean gestational age of 21.80 ± 2.61 (range 18-27) weeks present in the inventory of Mersin University Faculty of Medicine Anatomy Department were dissected. Surface area of levator scapulae, rhomboid major, and rhomboid minor was calculated using digital image analysis software; width and length parameters were measured using digital calipers...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
Amélie Levesque, Thibault Riant, Stéphane Ploteau, Jérôme Rigaud, Jean-Jacques Labat
Background: The evaluation of chronic pelvic and perineal pain (CPP) is often complex. The patient's description of the pain often appears to be disproportionate to the limited findings on physical examination and/or complementary investigations. The concept of central sensitization may allow better understanding and management of patients with CPP. Objective: The aim of this study was to elaborate a clinical evaluation tool designed to simply identify sensitization in pelvic pain...
March 7, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
V Piloni, M Bergamasco, G Melara, P Garavello
BACKGROUND: The aim of the present study was to assess the relationship between symptoms of obstructed defecation and findings on magnetic resonance (MR) defecography in males with obstructed defecation syndrome (ODS). METHODS: Thirty-six males with ODS who underwent MR defecography at our institution between March 2013 and February 2016 were asked in a telephone interview about their symptoms and subsequent treatment, either medical or surgical. Patients were divided into 2 groups, one with anismus (Group 1) and one with prolapse without anismus (Group 2)...
March 6, 2018: Techniques in Coloproctology
Camila C Araujo, Suelene S A Coelho, Natalia Martinho, Mariana Tanaka, Rodrigos M Jales, Cassia R T Juliato
INTRODUCTION AND HYPOTHESIS: We used clinical examination and transperineal 3D/4D ultrasound (US) to evaluate pelvic floor muscles (PFM) after different delivery modes. METHODS: Women were surveyed using validated questionnaires. PFM were evaluated and classified according to the Modified Oxford Scale following 3D/4D transperineal US. For statistical analysis, Kruskal-Wallis, Mann-Whitney, chi-square, and Fisher exact tests were used. RESULTS: Fifty-three women were evaluated: 32 with previous vaginal delivery (VD) and 21 with cesarean section (CS) (8 nonelective and 13 elective)...
March 6, 2018: International Urogynecology Journal
Stéphanie Thibault-Gagnon, Corrie Goldfinger, Caroline Pukall, Susan Chamberlain, Linda McLean
BACKGROUND: Digital intravaginal palpation remains the favored method for clinical assessment of pelvic floor muscle (PFM) function in women; however, there is growing interest in using transperineal ultrasound imaging (TPUSI). TPUSI does not involve vaginal penetration, making it particularly relevant for PFM assessment in women with genito-pelvic pain and penetration disorders. AIMS: To study the relations between measures of PFM morphology and function assessed using 3-dimensional (3D) TPUSI and PFM assessment through intravaginal palpation...
March 2018: Journal of Sexual Medicine
J X Zhang, Z Yang, P Fan, J J Zhang, L Xin, L N Hou, X S Du, X T Yang
Objective: To evaluate the predictive value of MRI features and pathological parameters on local recurrence, metastasis and progression free survival (PFS) for locally advanced rectal cancer after neoadjuvant chemoradiotherapy and subsequent total mesorectal excision surgery. Methods: A retrospective analysis of 95 patients with locally advanced rectal adenocarcinoma who underwent total mesorectal excision after neoadjuvant chemoradiotherapy was performed. Univariate and multivariate analyses were performed to evaluate the predictive value of MRI features before chemoradiation and postoperative pathological parameters on progression free survival...
February 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
Alex Mowat, Declan Maher, Kaven Baessler, Corina Christmann-Schmid, Nir Haya, Christopher Maher
BACKGROUND: Posterior vaginal wall prolapse (also known as 'posterior compartment prolapse') can cause a sensation of bulge in the vagina along with symptoms of obstructed defecation and sexual dysfunction. Interventions for prevention and conservative management include lifestyle measures, pelvic floor muscle training, and pessary use. We conducted this review to assess the surgical management of posterior vaginal wall prolapse. OBJECTIVES: To evaluate the safety and effectiveness of any surgical intervention compared with another surgical intervention for management of posterior vaginal wall prolapse...
March 5, 2018: Cochrane Database of Systematic Reviews
Ryo Ohta, Takahiro Inoue, Manabu Goto, Yuji Tachimori, Koji Sekikawa
INTRODUCTION: This report presents a case of anorectal malignant melanoma treated with combined laparoscopic abdomino-endoscopic perineal total mesorectal excision. PRESENTATION OF CASE: An 82-year-old female presented with hematochezia. Colonoscopy revealed a 5-cm tumor in the anorectal junction, and biopsy specimen showed malignant melanoma. Modified ransanal total mesorectal excision was performed to get the sufficient surgical resection margins. After lymph node dissection in usual manner, mobilizing the rectum to the level of levator ani muscle...
February 22, 2018: International Journal of Surgery Case Reports
Hamama Jalal, Khalfi Lahcen, Sabani Hicham, El Khatib Karim
INTRODUCTION: Severe ptosis of more than 4mm with poor levator function of less than 4mm is treated via the frontalis muscle suspension technique using autogenous temporal fascia. TECHNICAL NOTE: The surgery was performed under general anaesthesia. The eyelid crease was incised and the tarsus exposed. An incision centered on the mid-pupillary level was then made just above the eyebrow with exposure of the frontalis muscle. The temporal fascia strip was sutured to the tarsus at three points...
February 27, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Anamika Sharma, Shatakshi Sharma, Harshita Garg, Vineeta Singhal, Pooja Mishra
This clinical report describes the successful use of lip repositioning technique for the reduction of excessive gingival display. The lip repositioning technique was performed with the main objective of reducing gummy smile by limiting the retraction of elevator muscles (e.g., zygomaticus minor, levator anguli, orbicularis oris, and levator labii superioris). This technique includes removing a strip of mucosa from the maxillary buccal vestibule, creating a partial-thickness flap between mucogingival junction and upper lip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display...
October 2017: Journal of Cutaneous and Aesthetic Surgery
Arun K Gosain, Harvey Chim, Walter M Sweeney
OBJECTIVE: The present study investigates the efficacy of performing a "palate rerepair" utilizing a double-opposing z-palatoplasty (DOZ) following primary Furlow palatoplasty. DESIGN: Retrospective study. SETTING: Tertiary referral academic center for craniofacial surgery. PATIENTS: 15 consecutive patients who presented with velopharyngeal insufficiency (VPI) after primary Furlow palatoplasty. MAIN OUTCOME MEASURES: All subjects were evaluated using the perceptual speech assessment (PSA) scale...
January 1, 2018: Cleft Palate-craniofacial Journal
Franziska Hampel, Peter Hallscheidt, Christof Sohn, Bettina Schlehe, Kerstin A Brocker
AIMS: To perform pelvimetry in nulliparous and primiparous women using 3 Tesla magnetic resonance imaging (3T MRI). METHODS: Twenty-five nulliparous volunteers and 25 primiparous women underwent pelvic 3T MRI within one week after vaginal childbirth in a prospective clinical single-center trial. The pelvimetric parameters interspinous distance (ISD), intertuberous distance (ITD), sagittal outlet (SO), obstetric conjugate (OC), and coccygeal curved length (CCL) were adapted from anthropometric measurements as well as from sonographic and computed tomography-based pelvimetry performed on high-resolution T2-weighted images...
February 21, 2018: Neurourology and Urodynamics
Sarah Fradet, Mélanie Morin, Jennifer Kruger, Chantale Dumoulin
Purpose: Urinary incontinence (UI) affects as many as 50% of women aged 60 years and older, but UI pathophysiology, specifically in elderly women, remains unclear. A better understanding of morphometric differences between continent and urinary incontinent elderly women is needed to improve the effectiveness of conservative treatment approaches. We hypothesized that morphometric differences in the pelvic floor muscles (PFM) among elderly women with and without UI could be observed using three- and four-dimensional (3D/4D) transperineal ultrasound (TPU) imaging...
2018: Physiotherapy Canada. Physiothérapie Canada
Ahmed Elsherbiny, Meghan Amerson, Laura Sconyers, John H Grant
OBJECTIVES: Palatal re-repair aims to improve velar function by retro-positioning the levator veli palatini muscles. The surgery includes extensive dissection, leading to tissue edema and scar formation which may need time to remodel. Together with the change of muscle orientation and tension, it is expected that a period of time is needed to reach the final functional performance. This study attempts to determine how much time is required to reach the optimum performance of the palate after re-repair...
February 5, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Francisco J Orejuela, Rajshi Gandhi, Lauren Mack, Wesley Lee, Haleh Sangi-Haghpeykar, Hans P Dietz, Susan M Ramin
INTRODUCTION AND HYPOTHESIS: The objective was to assess the safety and feasibility of using a pelvic floor dilator during active labor to prevent injuries to the levator ani muscle (LAM) and perineum. METHODS: In a prospective pilot study, a pelvic floor dilator using soft pads was introduced into the vaginal canal to gradually expand the vagina, in 30 nulliparous women and in 10 controls. The primary outcomes were adverse events related to the device. Secondary outcomes were perineal lacerations after delivery, sonographically defined levator ani injury, hiatal area dimensions, and anal sphincter disruption, all at 12-20 weeks postpartum, and maximum pelvic floor dilation, time to achieve maximum dilation, and device retention rate...
February 6, 2018: International Urogynecology Journal
Mitchell B Berger, Giselle E Kolenic, Dee E Fenner, Daniel M Morgan, John O L DeLancey
BACKGROUND: Prolapse of the anterior and posterior vaginal walls has been generally associated with apical descent and levator ani muscle defects. However, the relative contributions of these factors to the pathophysiology of descent in the different vaginal compartments is not well understood. Furthermore, symptoms uniquely associated with prolapse in these compartments have not been well-characterized. OBJECTIVES: Compare associations between: 1) apical support, 2) levator ani muscles, and 3) pelvic floor symptoms in women with posterior-predominant prolapse, anterior-predominant prolapse, and normal support...
January 31, 2018: American Journal of Obstetrics and Gynecology
Jennifer Malik, Samir N Ghadiali
BACKGROUND: The Eustachian tube is a collapsible upper respiratory airway that is periodically opened to maintain a healthy middle ear. Young children, <10 years old, exhibit reduced Eustachian tube opening efficiency and are at risk for developing middle ear infections. Although these infections increase mucosal adhesion, it is not known how adhesion forces alters the biomechanics of Eustachian tube opening in young children. This study uses computational techniques to investigate how increased mucosal adhesion alters Eustachian tube function in young children...
January 27, 2018: Clinical Biomechanics
Jessica Caudwell-Hall, Ixora Kamisan Atan, Chris Brown, Rodrigo Guzman Rojas, Susanna Langer, Ka Lai Shek, Hans Peter Dietz
INTRODUCTION: Levator trauma is a risk factor for development of pelvic organ prolapse. We aimed to identify antenatal predictors for significant damage to the levator ani muscle during first vaginal delivery. MATERIALS AND METHODS: A retrospective observational study utilising data from two studies with identical inclusion criteria and assessment protocols between 2005 and 2014. 1148 primiparae with an uncomplicated singleton pregnancy were recruited and assessed with translabial ultrasound at 36 weeks antepartum and 871 (76%) returned for reassessment 3-6 months postpartum...
February 2, 2018: Acta Obstetricia et Gynecologica Scandinavica
Lilah Inzelberg, David Rand, Stanislav Steinberg, Moshe David-Pur, Yael Hanein
Human facial expressions are a complex capacity, carrying important psychological and neurological information. Facial expressions typically involve the co-activation of several muscles; they vary between individuals, between voluntary versus spontaneous expressions, and depend strongly on personal interpretation. Accordingly, while high-resolution recording of muscle activation in a non-laboratory setting offers exciting opportunities, it remains a major challenge. This paper describes a wearable and non-invasive method for objective mapping of facial muscle activation and demonstrates its application in a natural setting...
February 1, 2018: Scientific Reports
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