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- Creators: Barrett, The Honors College
Description
In this study, we propose and then assess the efficacy of a new approach to static suspension to correct for facial paralysis. Our method involves placing barbed sutures through the superficial muscular aponeurotic system (SMAS) and anchoring them in the temporal fascia parallel to the underlying facial muscles. We first analyzed the ability of this procedure to improve facial symmetry by comparing the degree of asymmetry between the paralyzed and unaffected sides of a patient's face (N=10) prior to and following surgery. Then, to determine if symmetry is improved as a result of placing the sutures parallel to the direction of facial muscle forces, we measured the vectors of levator labii superioris and zygomaticus major in cadaver hemifaces (N=3) and compared them to the angles of the vectors of correction from the patient sample to angles of muscle vectors in three facial hemispheres from cadaver controls. Results indicate that: (1) facial symmetry was significantly improved in these patients and (2) this improvement. We conclude that, compared to existing protocols, our novel surgical method is a better means of static suspension for reconstruction following onset of facial paralysis as it is simple to perform, easy to replicate, able to be post-operatively adjusted in-office, has a good long-term prognosis, and, as we have demonstrated, effectively corrects the appearance of asymmetry by working with the underlying facial anatomy.
ContributorsLeach, Garrison Alecsander (Co-author) / Joganic, Jessica (Co-author) / Hooft, Nicole (Co-author) / Joganic, Edward (Co-author, Committee member) / Foy, Joseph (Thesis director) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
This thesis seeks to evaluate whether the benefits of spinal fusion surgeries are worth their increasing costs. The paper examines the trends that contribute to these surgeries' increasing prices and then evaluates the customer impact of these surgeries in order to make a conclusion on whether the surgeries are worth it. This paper discusses the main factors that contribute to the increase in prices of these surgeries and these include the aging population, the increase in diabetes rates, and the practice of purchasing physicians owned distributorships (PODs) devices in some hospitals. The paper concluded that there is a definite correlation between the increased rate of spinal surgeries performed as a result of an increase in diabetes rates in the US population. It was argued that diabetes can lead to multiple spinal diseases which increase the demand of spinal surgeries which in turn causes the prices of these surgeries to rise. The paper also argued that current technological advances have allowed us to live longer which in turn leads to an increase in spine surgeries simply due to old age and a deteriorating spine. Lastly, it was argued that the recent surge in the POD devices being used in spinal surgeries in some hospitals can be seen as a possible influence to the increase in the cost of these surgeries. This is because the hospitals that chose to purchase surgery devices from PODs are more likely to increase the cost to perform the surgery because they are paying a lot more for those devices. Looking at the customer impact, it was apparent that spinal fusion surgeries carry certain risks because they require decortication of bone and, often, placement of implants; along with extensive dissection and longer operative time. However, based on the research conducted, there was no conclusion to be made on whether spinal fusions carried more risks than all other spinal surgeries because the data used only compared the surgery to some that are arguably less complicated like discectomies.
ContributorsDisengi Nkunzi, Jossel (Author) / Allenby, Braden (Thesis director) / Bohl, Michael (Committee member) / Barrett, The Honors College (Contributor)
Created2017-12