- Email: [email protected]
How successful is TMJ disc suturing?
1097
CURRENT LITERATURB surgery, minimal access surgery, video-assisted surgery, video-controlled surgery, and endoscopic surgery. MIS involves operating on deep tissues through Teflon (DOW Chemical Co., Wilmington, DE) ports introduced with sharp trocars. Visualization of the surgical field is made possible using a fiber-optic video camera. The operating and visual space is maintained by insufflation with COZ. After flap mobilization, the free tissue is extracted through a port dilated to 30 mm. Pilot studies have successfully been performed on pigs, dogs, and cadavers with harvest of jejunum, rectus abdominis, and latissimus dorsi. In humans, the patient should be prepared for an open procedure if visualization is poor. Although MIS is still in its infancy, decreased morbidity, cost containment, and limited scar formation at harvest sites are advantages. MIS technology is advancing rapidly.-R.H. HAUG Reprint requests to Dr Miller: Department of Reconstructive and Plastic Surgery, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd. Houston, TX 77020. Invasive Transitional Cell Carcinoma of the Lacrimal Sac Arising in an Inverted Papilioma. Anderson KK, Lessner AM, Hood MB. Arch Ophthalmol 112:306, 1994 The incidence of tumor in the lacrimal sac is very rare. Transitional cell carcinoma is even more infrequent. The
author presents a case of a 36-year-old white man with an inverted papilloma of the lacrimal sac determined by incisional biopsy. The lesion was fully excised 2 months later, and histopathologic examination showed a transitional cell carcinoma arising within an inverted papilloma. The initial complaint was a mass in the medial canthal of the left eye associated with epiphora of 4 months’ duration. Physical examination showed a nontender, firm, elevated mass above and below the left medial canthal tendon. Irrigation showed a high-grade obstruction distal to the common internal canaliculus. There was no exudate seen. A dacryocystorhinostomy was attempted but not completed because the tumor was found within the nasolacrimal sac. Postoperative computed tomography showed a 2-cm solid hyperdense mass within the nasolacrimal sac and duct with mild bony erosion along the posterior aspect of the nasal bone. Two months later, the patient underwent a left medial maxillectomy and dacryocystectomy through standard Freeman-Wright incision. Histologically, the tumor proved to be an invasive transitional cell carcinoma. The patient was treated with radiation therapy. Three-month follow-up showed no evidence of recurrence. The author recommended thorough radiologic evaluation of the extent of a nasolacrimal sac mass in the planning and selection of an optimal surgical procedure for tumor of the lacrimal sac--M. S-C Kuo Reprint requests to Dr Anderson: Research to Prevent Blindness Inc, New York, NY.
CURRENT LITERATURB surgery, minimal access surgery, video-assisted surgery, video-controlled surgery, and endoscopic surgery. MIS involves operating on deep tissues through Teflon (DOW Chemical Co., Wilmington, DE) ports introduced with sharp trocars. Visualization of the surgical field is made possible using a fiber-optic video camera. The operating and visual space is maintained by insufflation with COZ. After flap mobilization, the free tissue is extracted through a port dilated to 30 mm. Pilot studies have successfully been performed on pigs, dogs, and cadavers with harvest of jejunum, rectus abdominis, and latissimus dorsi. In humans, the patient should be prepared for an open procedure if visualization is poor. Although MIS is still in its infancy, decreased morbidity, cost containment, and limited scar formation at harvest sites are advantages. MIS technology is advancing rapidly.-R.H. HAUG Reprint requests to Dr Miller: Department of Reconstructive and Plastic Surgery, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd. Houston, TX 77020. Invasive Transitional Cell Carcinoma of the Lacrimal Sac Arising in an Inverted Papilioma. Anderson KK, Lessner AM, Hood MB. Arch Ophthalmol 112:306, 1994 The incidence of tumor in the lacrimal sac is very rare. Transitional cell carcinoma is even more infrequent. The
author presents a case of a 36-year-old white man with an inverted papilloma of the lacrimal sac determined by incisional biopsy. The lesion was fully excised 2 months later, and histopathologic examination showed a transitional cell carcinoma arising within an inverted papilloma. The initial complaint was a mass in the medial canthal of the left eye associated with epiphora of 4 months’ duration. Physical examination showed a nontender, firm, elevated mass above and below the left medial canthal tendon. Irrigation showed a high-grade obstruction distal to the common internal canaliculus. There was no exudate seen. A dacryocystorhinostomy was attempted but not completed because the tumor was found within the nasolacrimal sac. Postoperative computed tomography showed a 2-cm solid hyperdense mass within the nasolacrimal sac and duct with mild bony erosion along the posterior aspect of the nasal bone. Two months later, the patient underwent a left medial maxillectomy and dacryocystectomy through standard Freeman-Wright incision. Histologically, the tumor proved to be an invasive transitional cell carcinoma. The patient was treated with radiation therapy. Three-month follow-up showed no evidence of recurrence. The author recommended thorough radiologic evaluation of the extent of a nasolacrimal sac mass in the planning and selection of an optimal surgical procedure for tumor of the lacrimal sac--M. S-C Kuo Reprint requests to Dr Anderson: Research to Prevent Blindness Inc, New York, NY.