Outcomes and patient satisfaction after Penuma silicone implant surgery via two surgical approaches.

Background: The Penuma is a soft silicone penile implant designed for cosmetic enhancement of the flaccid penis in men who have normal erections. Objectives: The goal of this study is to report outcomes on patient satisfaction at least 6 months after Penuma subcutaneous penile implant for cosmetic enhancement of the penis, and to determine if modifications in surgical approach resulted in reduction in postoperative complications. Design: Penile measurements, adverse events, and patient satisfaction were compared between patients undergoing the new lateral scrotal incision versus the traditional infrapubic approach. Methods: A retrospective chart review was performed on all patients who underwent a Penuma implant by a single surgeon from April 2019 to December 2022. A 26-item non-validated device-specific questionnaire was sent to patients at least 6 months after the date of their initial surgery. Results: A total of 92 cases were performed by a single surgeon. The average increase in flaccid length was 2.5 cm (±2.2), representing a 44% increase (p < 0.01). The average increase in girth was 3.1 cm (±1.8 cm), a 32% change (p < 0.01). Seroma requiring drainage occurred in 12%. 7% of patients required operative revision of the implant. When assessed by surgical approach, the revision rate was significantly higher in infrapubic patients (13% vs 2%, p < 0.05). The implant removal rate was also significantly higher when the infrapubic approach was used (21% vs 6%, p < 0.05). 82% of patients reported being satisfied or very satisfied with their postoperative penile appearance. 75% of patients would undergo surgery again. Conclusion: The subcutaneous Penuma penile implant appears to improve satisfaction with regard to the appearance of the penis and is a viable option for men who desire to enhance flaccid penile length and girth. Furthermore, the lateral scrotal surgical approach appears to have a lower postoperative complication rate.

Oral/Perioral Reactions to Injectable Soft Tissue Fillers: A Clinicopathological Multicentric Study.

OBJECTIVE: To analyze the characteristics of a series of oral reactions to injectable soft tissue fillers. MATERIALS AND METHODS: Cases diagnosed as oral reactions to injectable soft tissue fillers were selected from eight Pathology laboratories. Information was retrieved from the laboratory charts and from the review of the hematoxylin and eosin-stained histological slides. RESULTS: The 151 patients showed a mean age of 54.9 years, and 136 (90.1%) were females. Mean time of onset was 20.4 months, and the lips were the most frequent location (72.8%). Most cases presented as asymptomatic isolated nodules, with a mean size of 17.4 mm. Silicone (38.5%), polymethylmetacrylate (33%), and hyaluronic acid (11.9%) were the three most common fillers. Granulomas, foamy macrophages, and multinucleated giant cells were observed in 44%, 51.5%, and 65.3% of the cases, respectively. Time of onset was shorter for males (p = 0.033), and symptoms were common in the upper lip, buccal mucosa, and lower vestibule (p = 0.010). Foamy macrophages were more common in association with silicone and collagen (p < 0.001), whereas multinucleated giant cells were more common in association with polymethylmetacrylate, hydroxiapatite, and polylactic acid (p = 0.012). CONCLUSION: Clinicians should consider reactions to injectable soft tissue fillers when evaluating asymptomatic submucosal nodules affecting the lips of adult/older females.

Effect of Ultraviolet-C Light Exposure Time on the Dimensional Stability of Addition Silicone Dental Impressions: An In Vitro Study.

AIM: To compare the effect of different ultraviolet-C (UV-C) light exposure times on the dimensional stability of addition silicone dental impressions. MATERIALS AND METHODS: The dimensional stability of the addition silicone dental impressions was assessed by measuring specific dimensions on dental casts that were recovered from an upper acrylic resin model of dental implants. The impressions were reproduced using a customized tray adapted in a three-point simplex dental articulator permitting only opening and closing movements. Addition silicone dental impressions were divided into five groups (N = 12) according to the UV-C light exposure time. Group A was untreated; group B received 10 minutes; group C, 20 minutes; group D, 30 minutes; and group E, 40 minutes. All the impressions were poured with type IV dental stone and the internal edges of the upper silicone retainers of impression copings were used as five reference points (E, D, C, B, and A) to determine six linear measurements between ED, CB, EA, AD, EB, and CD points using a traveling microscope of 0.001 mm accuracy. One-way analysis of variance (ANOVA) was used for the statistical analysis (p < 0.05). RESULTS: Expansion and contraction were noted among ED, CB, EA, and EB measurements, whereas only expansion was noted among AD and CD measurements. The ANOVA analysis showed there was no significant difference in the arithmetic means for the measurements between and within group A and the other groups (p > 0.05). CONCLUSION: The UV-C light exposure time of 10, 20, 30, and 40 minutes did not have any negative effect on the dimensional stability of the addition silicone dental impressions evaluated. CLINICAL SIGNIFICANCE: In the daily routine dental practice, dental impressions need to be washed and disinfected immediately after making to prevent cross-infections. The UV-C light has been proposed as a promising method for disinfection, but only a few studies have been published about its effect on the dimensional stability of dental silicones. How to cite this article: Bravo-Cueto AG, Tinedo-López PL, Malpartida-Carrillo V. Effect of Ultraviolet-C Light Exposure Time on the Dimensional Stability of Addition Silicone Dental Impressions: An In Vitro Study. J Contemp Dent Pract 2024;25(6):507-513.

Silicone Irregular Hexagon Pessary Versus Polyvinyl Chloride Ring Pessary for Pelvic Organ Prolapse: Randomised Controlled Trial.

INTRODUCTION AND HYPOTHESIS: Vaginal pessaries are the mainstay of the non-surgical management of pelvic organ prolapse (POP). A flexible silicone irregular hexagonal (SIH) pessary was developed based on the results of a prior vaginal case study. We hypothesised that the SIH pessary would have a higher rate of retention and self-management than the polyvinyl chloride (PVC) pessary. METHODS: This was a prospective non-blinded, randomised controlled trial with institutional review board approval. Eligible participants were randomised and fitted with the assigned pessary. They were reviewed 1 week, 6 months and 1 year after the initial pessary fitting. Participants who returned for follow-up completed the study questionnaires. The primary outcome was success, defined as continued use of the allocated pessary at 6 months. Secondary outcomes included the ability to perform pessary self-care, treatment satisfaction and pessary-related complications. Statistical tests were performed with alpha or statistical significance defined as a p value of ≤ 0.05, two-tailed. RESULTS: A total of 104 participants were randomised, with 52 subjects in each arm. Primary outcome data were analysed using per protocol analysis. Continuing pessary usage at 6 months was 68.1% for the PVC pessary group and 65.1% for the SIH group, with no statistically significant differences between the two groups (p = 0.765). Subjects with SIH were more likely to perform pessary self-care. There were no significant differences in subjects' satisfaction, quality-of-life scores or treatment complications between groups. CONCLUSIONS: The pessary continuation rate between the SIH and the PVC pessary groups was similar at 6 months. Participants with an SIH pessary were more likely to self-manage.

Diagnosis and treatment of patulous Eustachian tube.

Symptoms of patulous Eustachian Tube (PET) were first described by Jago in 1858 and reported by Schwartze in 1864, recognizing PET as a clinical entity. This review summarizes the causes, epidemiology, diagnosis, and treatment of PET, with a particular emphasis on diagnosis and treatment, detailing the diagnostic criteria and silicone plug (Kobayashi plug) surgery proposed or developed in Japan. PET is often linked to weight loss from chronic illnesses, dieting, anorexia nervosa, hemodialysis, and bariatric surgery. It is also associated with pregnancy, oral contraceptive use, nasopharyngeal and muscular atrophy or scarring, and neuromuscular diseases. Interestingly, many PET cases lack an identifiable cause. The prevalence of PET ranges from 0.3 % to 7.0 %, with a higher incidence in females and typically occurring in adolescents and adults. Diagnosis relies on a combination of clinical history, physical examination, ET function test, and imaging. The Japan Otological Society (JOS) proposed standardized diagnostic criteria, where a "definite PET" diagnosis requires all three criteria (aural symptoms, tubal obstruction procedures, and objective findings), while "possible PET" requires two. Treatment includes conservative and surgical interventions. For persistent and severe cases that do not improve with conservative treatments, surgical options are explored. These surgical procedures are classified by the type of intervention, which includes tympanic membrane manipulation (such as tympanostomy tube insertion and mass loading of the tympanic membrane), plug surgery, ET injection, shim surgery, tuboplasty, and ET closure. The Kobayashi plug, a 23 mm long silicone plug, is specifically designed for PET treatment. Indications for its use include "definite PET," a PHI-10 score of 26 or higher, and lack of improvement after six months of conservative treatment. Preoperative evaluations include CT scans to assess ET patency and confirm the bony portion. Surgery, mostly performed under local anesthesia, involves inserting the plug into the ET via a myringotomy, ensuring the correct size and position with endoscopic guidance. In conclusion, PET is a challenging condition with diverse etiologies and symptoms. Effective management requires a comprehensive diagnostic approach and tailored treatment plans, with the Kobayashi plug offering a promising solution for refractory cases. Further research and advancements in diagnostic techniques and therapeutic interventions will continue to enhance the management of PET.

Determining personal exposure to high production volume chemicals (HPVCs) and polycyclic aromatic hydrocarbons (PAHs) with silicone wristbands: A pilot study.

High production volume chemicals (HPVCs) and polycyclic aromatic hydrocarbons (PAHs) are semi-volatile organic compounds (semi-VOCs) of great environmental concern because of their presence worldwide and health problems resulting from long-term exposure to some of them. It is essential to have robust analytical methods to monitor the concentrations of these compounds not only in environmental samples but also individual exposure. In this pilot study we develop and validate a multiresidue analytical method based on ultrasound-assisted extraction and gas-chromatography mass spectrometry for the simultaneous determination of 56 semi-VOCs using silicone wristbands (SWBs) as personal passive samplers. The developed method provided recoveries between 43% and 114% on sampled SWBs and method detection and quantification limits in the range of 0.1 - 35 ng/g and 0.3 - 119 ng/g, respectively. A preliminary study was performed with a small group of adults living in the industrial city of Tarragona (north-eastern Spain) to evaluate the applicability of SWBs for monitoring individual exposure to the studied HPVCs and PAHs. Benzothiazoles, benzenesulfonamides, UV stabilisers and phenolic antioxidants were determined for the first time in SWBs. Phthalates (PAEs), stood out above the rest, accounting for 52% of the total concentrations. Diethylhexyl phthalate was the compound found at the highest concentrations with values between 1.1 - 82 µg/g. Carcinogenic and non-carcinogenic dermal risk assessment was performed for adults and considering two scenarios (low and high). PAHs were the compounds with the highest carcinogenic and non-carcinogenic dermal risk regardless of the exposure scenario. The second family of compounds that contributed the most to the total risk were PAEs but high punctual concentrations of these compounds caused significant differences between exposure scenarios.

Retinal vascular changes after Silicon Oil removal in the Eye with Rhegmatogenous Retinal detachment.

BACKGROUND: This study aims to examine vessel density changes in the optic nerve and macula following silicone oil removal (SOR) surgery in eyes with rhegmatogenous retinal detachment (RRD) at different time points by Optical Coherence Tomography Angiography (OCTA) in compared to the contralateral eye. METHODS: A total of 43 eyes from 43 patients with silicone oil in their eyes for 3-9 months underwent OCT-A using AngioVue and optic disc-associated vessel density (VD) and thickness, macular-associated VD and thickness, Foveal avascular zone (FAZ) area, FAZ perimeter (PERIM), Acircularity index (AI), vessel density within a 300 µm wide region of the FAZ were compared between eyes. OCTA scans were performed one week before SOR and one month and three months after SOR. RESULTS: The mean age of participants was 52.8 years (SD = 15.85) and a median visual acuity was 0.8 (range: 0.5-1.0). Notably, male participants constituted 67.4% of the sample. The preoperative mean value BCVA (logMAR) of patients was 0.73, and 3 months post-oil removal was 0.7727. Regarding optic disc parameters, RNFL thickness and vessel density (VD) measurements Peripapillary, whole disc, inside disc, and Disc Angio (superior, Nasal, inferior, temporal) did not change. In analyzing macular thickness parameters, all of them (Whole and Fovea, parafoveal, and Perifovea) remained unchanged. Examining macular vessel density parameters revealed no significant changes across superficial and deep retinal layers. Finally, the comparison of the foveal avascular zone (FAZ) area and flow density (FD) parameters demonstrated consistent measurements with non-significant alterations observed in FAZ size (p = 0.6) and FD values (p = 0.49) over the monitored duration. CONCLUSION: There was no change in peripapillary VD and macular vessel density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) after silicone oil removal. FAZ and full retinal thickness  remained stable 3 month after SOR.  Clinical trial number: Not applicable.

Multi-layered silicone-based breast tissue phantom for multi-modal optical spectroscopy.

The heterogeneity, non-uniform nature, and ethical concerns in sourcing biological tissues pose several challenges to designing, calibrating, standardizing, and evaluating the performance of spectroscopy-based diagnostic methods. A synthetic phantom module that can resemble a multi-layered tissue structure while including multiple tissue biomarkers with long-shelf life and stability is vital to overcome these challenges. This work uses a multi-layered silicone phantom to incorporate multiple biomarkers suitable for multi-modal spectroscopy testing and calibration. The phantom mimics the microcalcification distribution in the breast tissues using hydroxyapatite and the endogenous fluorescence seen in the tissues using Flavin Adenine Dinucleotide (FAD) and Nicotinamide Adenine Dinucleotide (NADH). The utility of this phantom for tumor margin analysis is analyzed using Diffuse reflectance, fluorescence, and Raman spectroscopy. The observed relative differences in intensity with changes in the silicone tumor layer depth and thickness are suitable for instrument calibration and fiber-optic probe design for tumor margin analysis. .

International trends in prescribing silicone hydrogel contact lenses for daily wear (2000-2023): An update.

PURPOSE: Introduced around the turn of the 21st century, silicone hydrogel contact lenses alleviated hypoxic anterior eye complications due to their high oxygen transmissibility. The purpose of this work is to update earlier surveys by describing international trends in silicone hydrogel daily wear contact lens fitting between 2000 and 2023. METHOD: An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023. Data relating to 260,144 daily wear soft contact lens fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of silicone hydrogel daily wear contact lens fitting. RESULTS: There has been a dramatic increase in silicone hydrogel daily wear lens fits (p < 0.0001), increasing from 2.8 % of all daily wear soft lens fits in 2000 to 73.7 % in 2023. Of all daily wear soft contact lenses prescribed to males, 44.6 % were silicone hydrogel lenses, compared with 43.5 % for females (p = 0.0146). The mean age of those wearing silicone hydrogel daily wear lenses was 32.0 ± 14.5 years, compared to 30.4 ± 13.6 years for those wearing daily wear hydrogel lenses (p < 0.0001). Between 2019-2023, the average percentage of fits was - (a) material type: silicone hydrogel - 73 %; mid-water content hydrogels - 13 %; high water content hydrogels - 9 %; and low water content hydrogels - 5 %, and (b) lens design: spherical - 44 %, toric - 32 %, multifocal - 17 %, monovision - 4 %, and 'other' - 3 %. CONCLUSION: The dramatic increase in silicone hydrogel contact lens prescribing for daily wear has been commensurate with the introduction of multiple lens brands and an ongoing expansion of lens designs, parameters and replacement frequency options. The balance between silicone hydrogel and hydrogel lens prescribing is perhaps starting to approach an equilibrium.

The Effect of Chemical Disinfectants on Maxillofacial Silicone With the Addition of Silver Nanoparticles: An Original Research.

Background and objective Silicone has emerged as the most widely accepted material for facial prosthesis fabrication. However, silicone materials have certain limitations. Several techniques have been investigated to lessen the degradation of the polymer, such as the use of nanoparticles and nano-oxides, etc. In this study, we aimed to evaluate the effect of various chemical disinfectants on color stability, hardness, and surface roughness of maxillofacial silicone, after the addition of silver nanoparticles. Materials and methods This was an in vitro study carried out in the Department of Prosthodontics, Sharad Pawar Dental College and Hospital; 80 samples of maxillofacial silicone incorporated with silver nanoparticles (in a concentration of 20 ppm) were fabricated in a mold of 3 x 10 mm dimension disc. The samples were then tested for surface roughness (using a digital roughness tester), Shore A hardness (using a durometer), and color stability (using a spectrophotometer). The samples were then classified into four groups according to various disinfectants used: sodium hypochlorite (1% w/w), chlorhexidine gluconate (0.2%), and neutral soap, and distal water was deemed the control group. After 48 hours, the samples underwent retesting to assess for changes in readings under the same parameters (i.e., surface roughness, Shore A hardness, and color stability) to obtain results, i.e., the samples were tested after fabrication, before immersion, and 48 hours after immersion in disinfectants. Results When taking into account the surface roughness, the maximum roughness value was observed in the sodium hypochlorite group and the least roughness value in distilled water (mean % change of 38.359 to negligible change in the distilled water group). As for the Shore A hardness, the maximum hardness value was seen in the sodium hypochlorite group and the least hardness value in distilled water (mean % change of 15.780 to 2.125 in distilled water). Regarding color stability, the maximum increase in color values was seen in the sodium hypochlorite group (mean: 2.4) followed by the neutral soap group (mean: 1.653); the chlorhexidine gluconate group (mean: -0.287) showed the maximum decrease in color value from the initial to the final phase. Conclusions Based on our findings, surface roughness altered the most when samples were immersed in 1% sodium hypochlorite disinfectant and the least when samples were immersed in neutral soap disinfectant. Shore A hardness altered the most when samples were immersed in 1% sodium hypochlorite disinfectant, but altered the least when samples were immersed in neutral soap disinfectant. Color stability altered the most when samples were immersed in neutral soap disinfectant, but altered the least when samples were immersed in 0.2% chlorhexidine gluconate. Disinfection with neutral soap seems to lead to fewer changes in physical properties (i.e., surface roughness and Shore A hardness) and hence is recommended as a disinfectant for silicone prosthesis. However, our study also showed that 0.2% chlorhexidine gluconate had the least effect on the parameter of color stability, and hence it could be the disinfectant of choice for prostheses with high esthetic requirements.

Troubleshooting Vaginal Stents: A Critical Review of Common Problems and Solutions.

This review aims to examine the use of vaginal stents in clinical practice, specifically for treating vaginal agenesis and related complications and problem associated with vaginal stents. Vaginal agenesis, also known as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, is a congenital disorder characterized by the uterus not developing or developing only partially. Vaginal stents are medical devices that preserve the structural integrity and patency of the vaginal canal after trauma or surgery. They play an important part in gynecological treatments such as post-radiation therapy, reconstructive surgery, and vaginal stenosis management. The review also discusses the primary applications of vaginal stents, such as preventing adhesions, healing mucosa, and maintaining patency. It also investigates frequent concerns associated with stent use, such as complications and the need for better designs. Vaginal stents are essential in a variety of therapeutic settings, providing major benefits in maintaining vaginal tissue and function. However, their use is fraught with complications, including the risk of infection, discomfort, and the possibility of inappropriate placement.

Electrostatic Dissipation in 3D-Printable Silicone.

In this report, we describe the incorporation of single-walled carbon nanotubes (CNTs) into 3D printable siloxane elastomers for electrostatic dissipation. The composite was characterized, focusing on how rheological and mechanical properties of the siloxane are affected at various CNT loading levels. Electrical properties were also characterized to develop materials with effective electrostatic dissipation. We demonstrate that low loadings (<1 wt %) of CNTs can be sufficiently dispersed into silicone resins that can be 3D printed, and the resulting material shows a significant improvement in electrostatic dissipation through the reduction in electrical resistivity with minimal effect on its mechanical properties.

The Effect of Cigarettes Smoke on the Color and Properties of a Silicone for Maxillofacial Prostheses.

Although deterioration of silicone maxillofacial prostheses is severely accentuated in smoking patients, the phenomenon has not been systematically studied. To address a gap in the literature concerning the stability of maxillofacial prostheses during service, in this contribution, the effect of cigarette smoke on the aspect and physical properties of M511 silicone elastomer was evaluated. The aspect, surface, and overall properties of the silicone material, pigmented or not, were followed by AFM, color measurements, FTIR, water contact angle measurements, TGA-DTG and DSC, hardness and compression stress-strain measurements. The types of the contaminants adsorbed were assessed by XRF, ESI-MS, MALDI-MS, and NMR spectral analyses. Important modifications in color, contact angle, surface roughness, local mechanical properties, and thermal properties were found in the silicone material for maxillofacial prostheses after exposure to cigarettes smoke. The presence of lead, nicotine, and several other organic compounds adsorbed into the silicone material was emphasized. Slight decrease in hardness and increase in Young's modulus was found. The combined data show important impact of cigarette smoke on the silicone physical properties and could indicate chemical transformations by secondary cross-linking. To our knowledge, this is the first study making use of complementary physical methods to assess the effect of cigarette smoke on the aspect and integrity of silicone materials for maxillofacial prostheses.

Silicone tags as an effective method of monitoring environmental contaminant exposures in a geographically diverse sample of dogs from the Dog Aging Project.

Introduction: Companion animals offer a unique opportunity to investigate risk factors and exposures in our shared environment. Passive sampling techniques have proven effective in capturing environmental exposures in dogs and humans. Methods: In a pilot study, we deployed silicone monitoring devices (tags) on the collars of a sample of 15 dogs from the Dog Aging Project Pack cohort for a period of 120 h (5 days). We extracted and analyzed the tags via gas chromatography-mass spectrometry for 119 chemical compounds in and around participants' homes. Results: Analytes belonging to the following chemical classes were detected: brominated flame retardants (BFRs), organophosphate esters (OPEs), polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), pesticides, phthalates, and personal care products. The types and amounts of analytes detected varied substantially among participants. Discussion: Data from this pilot study indicate that silicone dog tags are an effective means to detect and measure chemical exposure in and around pet dogs' households. Having created a sound methodological infrastructure, we will deploy tags to a geographically diverse and larger sample size of Dog Aging Project participants with a goal of further assessing geographic variation in exposures.

Capsular contracture in breast reconstruction: A systematic review and meta-analysis.

BACKGROUND: Capsular contracture after implant-based breast reconstruction is not an uncommon problem and affects reconstruction outcomes. It can be influenced by various factors, such as the plane of implant placement, implant surface and implant type. This systematic review and meta-analysis aimed to evaluate how the abovementioned risk factors can affect capsular contracture rates. METHODS: A systematic review and meta-analysis was performed. PubMed MEDLINE, EMBASE (OvidSP) and Cochrane Library were searched. Comparison groups included subpectoral versus prepectoral implant placement, smooth versus textured implants and saline versus silicone implants. Odds ratios (ORs) were calculated for capsular contracture for each group. The level of evidence was evaluated using the Oxford Centre for Evidence-Based Medicine. RESULTS: Twenty-three studies met the inclusion criteria. Sixteen studies compared subpectoral versus prepectoral implant placement, with no statistically significant differences in capsular contracture rates [OR, 1.21; 95% confidence interval (95% CI), 0.75-1.95; P = 0.44]. Five studies compared smooth versus textured implants, with no statistically significant differences in capsular contracture rates (OR, 0.99; 95% CI, 0.50-1.93; P = 0.97). Two studies compared saline versus silicone implants for capsular contracture. Patients receiving saline implants had significantly lower capsular contracture rates than silicone implants (OR, 0.19; 95% CI, 0.08-0.43; P < 0.0001). CONCLUSIONS: Implant-based breast reconstruction using saline implants demonstrated reduced capsular contracture rates compared to silicone implants. However, no significant differences were observed in capsular contracture rates between subpectoral versus prepectoral implant placement and smooth versus textured implants.

Randomized Controlled Trial on Silicone Intubation in Endoscopic Mechanical Dacryocystorhinostomy (SEND): An 11-year Outcome Report.

PURPOSE: To compare the long-term outcomes of mucosal-sparing mechanical endoscopic dacryocystorhinostomy (MMED) for primary acquired nasolacrimal duct obstruction (PANDO) with or without silicone intubation. METHODS: An 11-year follow-up study of the Silicone intubation in Endoscopic Dacryocystorhinostomy (SEND) randomized controlled trial (RCT) was conducted at a university-affiliated dacryology clinic from December 2019 to March 2023. Questionnaires on symptoms, anterior segment examination, endoscopic examination with functional endoscopic dye test (FEDT) and FICI grading, and ostial size measurements using Image J software were performed by a masked ophthalmologist. The primary outcome was surgical success, defined by Munk's score ≤1 and a positive fluorescein endoscopic dye test. Secondary outcomes included risk factors for failure and outcomes of revision surgeries. RESULTS: Fifty-three of the original 118 patients were evaluated at 155 ± 21 (136-218) months postoperatively. Seventy-seven percent (46/60) ostia remained successful, including 70% (19/27) of unstented and 82% (27/33) of stented ostia (p = .3). Stented ostia had larger size (p = .003), but this did not confer higher success (p = .14). Successful ostia had higher FICI scores and better ostial dynamicity (p < .05). Ostium movement was the only parameter associated with surgical success on multivariate analysis (OR 13.1, p = .01). Four (1 stented) underwent revision MMED, intraoperative mitomycin-C, and 12-week intubation. All revision ostia were functional after 141 ± 43 months. CONCLUSIONS: Surgical success of MMED after 11-years was 77%, a notable reduction compared to 96% success at 1-year. Statistical advantage of silicone intubation for primary MMED was not demonstrated, though clinically, stented ostia had a higher success (82% vs 70%). The presence of a dynamic internal common opening was highly associated with long-term surgical success.

A simple, novel technique to create silicone vessels for microsurgical training.

Background and objectives: Effective microsurgical training necessitates dedicated practice, prompting the development of simulation models that mitigate the hygiene risks, regulatory challenges, and storage difficulties associated with conventional biological models. This study aims to evaluate the preferences of microsurgeons and medical students regarding self-made silicone simulation vessels, comparing them to standard biological models. Methods: A three-part jig, comprising of a two-part metal clamp component and a transparent acrylic block with 4x4 channels, was designed. This assembly produced 16 vessels with a 1 â€‹mm inner diameter. Liquid silicone (Ecoflex 00-30), readily accessible from online distributors, was injected into the channels using a syringe. After tightening the clamp component and inserting 16 1 â€‹mm k-wires, the vessels were left to set for approximately 24 â€‹h 20 medical students with no prior microsurgical experience and 10 microsurgery-trained surgeons then evaluated these silicone vessels against a commonly used biological model (chicken brachial artery for surgeons or chicken aorta for students). Participants were then surveyed about their preference for a specific model for frequent practice using a 10-point Likert scale. Results and conclusion: In assessing ideal microsurgical training models, all participants highlighted the importance of realism. Surgeons' main practical considerations were hygiene, availability, and setup and storage ease, while medical students were primarily concerned with cost-effectiveness. Both surgeons and medical students perceived the biological model as more realistic, yet less hygienic and harder to set up and store. Conversely, the silicone model, though deemed less realistic, offered advantages in hygiene, availability, cost-effectiveness, and setup and storage simplicity. The silicone model emerged as the overall favorite amongst all participants for frequent practice. Silicone vessels may serve as a complementary adjunct to biological models, allowing surgeons-in-training to practice their skills outside of the operating room and lab settings.

Treatment of acute dacryocystitis by translacrimal canalicular drainage and D-silicone intubation.

AIM: To demonstrate the outcomes of translacrimal canalicular drainage using a lacrimal probe and intranasal drainage by D-silicone intubation for acute dacryocystitis (AD). METHODS: This retrospective study included 23 patients with AD and had undergone abscess decompression with the use of lacrimal probe and intranasal drainage by D-silicone intubation between January 2019 and December 2022. Patients received abscess decompression and systemic antibiotic-corticosteroid from the time of diagnosis. D-silicone tube was inserted within 10d after diagnosis and removed 3-6mo after intubation. The procedure and outcomes of this method were evaluated. RESULTS: All patients showed improvement of signs and symptoms of AD within 72h. No intraoperative and postoperative complications were observed. No recurrence of lacrimal sac abscesses occurred after D-silicone tube removed. CONCLUSION: Lacrimal probe and D-silicone intubation appear to be a feasible, minimally invasive, safe, and effective method, which could be a reasonable choice in the treatment of AD.

An imine-functionalized silicone-based epoxy coating with stable adhesion and controllable degradation for enhanced marine antifouling and anticorrosion properties.

Biofouling and corrosion of submerged equipment caused by marine organisms severely restrict the rapid development of the marine industry. Traditional antifouling or anticorrosion coatings typically serve a sole purpose and exhibit limited degradability upon failure, rendering them inadequate for current demands. Herein, a novel imine-functionalized command-degradable bio-based epoxy coating (SAHPEP-DDM) with enhanced integrated antifouling and anticorrosion performances was synthesized utilizing 1,3-bis (3-aminopropyl)-1,1,3,3-tetramethyldisiloxane and syringaldehyde. Compared with commercial epoxy resins (E51-DDM) and polydimethylsiloxanes (PDMS), the SAHPEP-DDM coating exhibits superior antifouling and anticorrosion properties due to the existence of -C=N- and Si-O-Si chain segments in the cross-linking network. The coating shows promising resistance against bacteria, algae and proteins, as well as excellent corrosion resistance in artificial seawater. The coating also exhibits excellent chemical resistance in organic solvents as well as neutral and alkaline environments. Moreover, its controlled degradation after failure can be achieved in acid aqueous solutions through temperature and acidity adjustments, facilitated by the presence of -C=N-. This work presents a novel degradable coating successfully coupled the dual functions of antifouling and anticorrosion coatings, avoiding the employment of intermediate coat, indicating vast potential for application in marine engineering fields.

Factors affecting the development of cystoid macular edema following pars plana vitrectomy with silicone oil placement: a retrospective cohort study.

BACKGROUND: Cystoid macular edema (CME) can develop following silicone oil placement in complex vitreoretinal surgeries, contributing to poor visual outcomes. In this study, we investigated the clinical and surgical characteristics associated with the development of CME following the use of silicone oil (SO) in pars plana vitrectomy (PPV) surgeries. METHODS: We conducted a retrospective chart review of patients who underwent implantation of SO during PPV from 2010 to 2020 by a single surgeon. Patient demographics, type of oil, duration of oil tamponade, retinectomy size, diabetic status, lens status, prior panretinal photocoagulation, visual acuity, and incidence of CME were reviewed. RESULTS: This study included 43 eyes from 40 patients who underwent SO tamponade for retinal detachment (RD) surgery. The mean duration of SO tamponade was 15.7 ± 12.7 months (range: 1-58 months). The most common indication for surgery was diabetic tractional RD (32.7%), followed by traumatic RD (16.3%) and rhegmatogenous RD with proliferative vitreoretinopathy (11.6%). Of the 43 eyes, 18 (41.9%) developed CME for the first time after PPV with SO placement, with 8 (44%) resolving within a year of oil removal. The mean duration for the development of CME was 9 months. A logistic regression model showed that a scleral buckle procedure and poor initial vision were statistically significant factors for predicting the development of CME (ORs: 11.65 and 16.06, respectively). Overall, 91% of the patients had stable or improved vision after surgery. CONCLUSIONS: The use of a scleral buckle procedure and poor initial vision are significant factors for predicting CME following silicone oil tamponade in PPV surgeries, with 41.9% of patients developing CME with an average duration of 9 months. Recognizing such factors can lead to early monitoring and prompt management of CME. MEETING PRESENTATION: Partial analyses were presented at the ASRS 2020 conference. CLINICAL TRIAL NUMBER: Not applicable.