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Aortic Aneurysm 3D Animation

Mohamed
18,361 Views · 2 years ago

Most intact aortic aneurysms do not produce symptoms. As they enlarge, symptoms such as abdominal pain and back pain may develop. Compression of nerve roots may cause leg pain or numbness. Untreated, aneurysms tend to become progressively larger, although the rate of enlargement is unpredictable for any individual. Rarely, clotted blood which lines most aortic aneurysms can break off and result in an embolus. They may be found on physical examination. Medical imaging is necessary to confirm the diagnosis. Symptoms may include: anxiety or feeling of stress; nausea and vomiting; clammy skin; rapid heart rate. In patients presenting with aneurysm of the arch of the aorta, a common symptom is a hoarse voice as the left recurrent laryngeal nerve (a branch of the vagus nerve) is stretched. This is due to the recurrent laryngeal nerve winding around the arch of the aorta. If an aneurysm occurs in this location, the arch of the aorta will swell, hence stretching the left recurrent laryngeal nerve. The patient therefore has a hoarse voice as the recurrent laryngeal nerve allows function and sensation in the voicebox. Abdominal aortic aneurysms, hereafter referred to as AAAs, are the most common type of aortic aneurysm. One reason for this is that elastin, the principal load-bearing protein present in the wall of the aorta, is reduced in the abdominal aorta as compared to the thoracic aorta (nearer the heart). Another is that the abdominal aorta does not possess vasa vasorum, hindering repair. Most are true aneurysms that involve all three layers (tunica intima, tunica media and tunica adventitia), and are generally asymptomatic before rupture. The most common sign for the aortic aneuysm is the Erythema nodosum also known as leg lesions typically found near the ankle area. The prevalence of AAAs increases with age, with an average age of 65–70 at the time of diagnosis. AAAs have been attributed to atherosclerosis, though other factors are involved in their formation. An AAA may remain asymptomatic indefinitely. There is a large risk of rupture once the size has reached 5 cm, though some AAAs may swell to over 15 cm in diameter before rupturing. Before rupture, an AAA may present as a large, pulsatile mass above the umbilicus. A bruit may be heard from the turbulent flow in a severe atherosclerotic aneurysm or if thrombosis occurs. Unfortunately, however, rupture is usually the first hint of AAA. Once an aneurysm has ruptured, it presents with a classic pain-hypotension-mass triad. The pain is classically reported in the abdomen, back or flank. It is usually acute, severe and constant, and may radiate through the abdomen to the back. The diagnosis of an abdominal aortic aneurysm can be confirmed at the bedside by the use of ultrasound. Rupture could be indicated by the presence of free fluid in potential abdominal spaces, such as Morison's pouch, the splenorenal space (between the spleen and left kidney), subdiaphragmatic spaces (underneath the diaphragm) and peri-vesical spaces. A contrast-enhanced abdominal CT scan is needed for confirmation. Only 10–25% of patients survive rupture due to large pre- and post-operative mortality. Annual mortality from ruptured abdominal aneurysms in the United States alone is about 15,000. Another important complication of AAA is formation of a thrombus in the aneurysm.

Revision Rhinoplasty before and after

Paul Nassif
9,680 Views · 2 years ago

http://www.rhinoplastyspecialist.com
One of the most common of all plastic surgery procedures is rhinoplasty, also commonly known as a nose job. Rhinoplasty surgery can serve dual purposes, creating a more aesthetically pleasing look and also helping breathing conditions, such as a deviated septum.. Whether it's because of a genetic defect or some kind of injury, many people have trouble breathing through their nose. A rhinoplasty can counteract this, clearing the airway so you can breathe freely. It can even repair a deviated septum, straightening it and removing any blockages in the airway.
Perfecting surgery with this three-dimensional structure (the nose) takes years to master and continues to improve. Little did we know that rhinoplasty maneuvers that were used three years ago could cause disastrous results today. Rhinoplasty surgery is forever evolving! My fellowship director, J. Regan Thomas, MD, told me something that I’ll never forget – “you haven’t learned anything about rhinoplasty until you’ve performed at least a thousand procedures and followed them for many years”. This statement epitomizes why fellowships are so valuable. Some of the needed experience and potential pitfalls are circumvented by first hand observing and learning the analysis, judgment, techniques, complication management and most importantly, results from a seasoned rhinoplasty surgeon. This is why I super-specialized in rhinoplasty surgery during my fellowship in Facial Plastic & Reconstructive Surgery. The training catapults you years ahead of many other surgeons that aren’t fortunate to have post-graduate training. Many cosmetic surgeons are taught that aggressive cartilage removal is a procedure of the past. Today’s concept is “less is more”. Less cartilage excision, cartilage repositioning, camouflage techniques, structural grafting and suturing techniques are being taught in most rhinoplasty courses and at our national meetings.
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