transnasal wiring

January 14, 2004

I haven't checked in with the group for awhile but I am Mason's mom

(if you've looked at the photos.) Mason is now 4 1/2 and getting

ready for another surgery. The other day we met with a couple of

doctor's and they plan to do transnasal wiring. i was wondering if

anyone has had any experiences with this? it sounds like quite a

procedure and i am concerned about Mason. Several months after the

transnasal wiring they plan to repair his slings and then they said

he wouldn't need another surgery until he had his " grown up face. "

At that time they will remove the wire and do a bone graph.

I look forward to hearing from any of you that may have some advice.

Thanks for all of your support! Becki Brethouwer (Madison, WI)

January 14, 2004

Wow these fishing weights sound so weird!

Lets hope someone's out there who'll be able to explain the

procedure.

Bernice

> I've never heard of a a transnasal wiring, but it almost sounds

like what

> they did to me when i was a kid. Of course they didn't use

wiring. They

> actually drilled a hole through my nose at the corners of the eyes

and used

> fishing weights. I'm not quit sure what the fishing weights did

though. I

> can remember when i got out of the hospital i had patches on both

my eyes.

> I wasn't allowed to take them off and of course being a 6 yr old i

wanted to

> see. I would pull my cheek down and lift my head so i could see

below the

> patch. Every time i did that a fishing weight would fall out and

i could

> never get it put back in right so my mom would know that i

was " peeking " .

>

January 15, 2004

I checked out the photos you posted and your Sami is a little cutie pie! How old was she when she had those surgeries? what order did she have them in?

Mason had his first surgery at 2 1/2 months. He had the slings put in at that time which made an incredible improvement in his little disposition. The transnasal wiring is the 2nd surgery he will have (probably in March.) They plan to repair his slings 3-6 months after that and then when he is older, remove the wire and do a bone graph. Will Sami have a bone graph or does the "meltable" plate take the place of that?

Would you mind telling me where you are located and the name of Sami's doctor? Mason's doctors are very good at what they do but they admit that these cases are far and few between so they are always looking for info. I would be interested in passing some of this along to them.

Thanks for sharing. You have definitely eased my mind about the recovery. I had pictured a much worse recovery.

Thanks again! Becki Brethouwer

thefelton4@... wrote:

My daughter, Sami, had the transnasal wiring last spring. The transnasal wiring was done with a small wire placed through the nasal septum to pull the corners of the eyes closer (corrects the telecanthus) and also gives them a more natural look with pointed inner corners. She also had multiple z-plasties also which were done with Z-like incisions to remove the extra skin folds. The surgeon also placed a "meltable" plate over the bridge of the nose which he said would melt over 6 months or so and give her a more prominent bridge instead of being flattened, as is commom with BPES. The surgery was about 3 1/2 hours long but she looked much better than I expected afterwards. There was some swelling at the bridge of the nose and just two small incisions on each

side of the nose by the inner corners and small incisions at the outer corners of the eyse that were sutured. She recovered well. The worst part was having the sutures removed. They can't use ones that disolve because of the swelling. They ended up giving her a sedative and holding her down. Never again. After that, she's always been given anesthesia for any suture removals.The transnasal wiring was very "tight" at first with very pointed corners. However, the surgeon thinks the sutures may have slipped and will make a decision later on as to if he wants to go back in and tighten them again.I have posted some pictures but will post one of her right after the transnasal wiring surgery.Patty

January 15, 2004

Sami's a beautiful girl! I had to smile back when I saw her pics. Thanks for

posting

them, Patty. Your description of the procedure is very helpful in helping me

prepare

for 's future of the same. And now I can also ask the doc more specific

questions. By the way, how old was Sami when she had the transnasal wiring?

> My daughter, Sami, had the transnasal wiring last spring. The transnasal

> wiring was done with a small wire placed through the nasal septum to pull the

> corners of the eyes closer (corrects the telecanthus) and also gives them a

more

> natural look with pointed inner corners. She also had multiple z-plasties

> also which were done with Z-like incisions to remove the extra skin folds.

The

> surgeon also placed a " meltable " plate over the bridge of the nose which he

> said would melt over 6 months or so and give her a more prominent bridge

instead

> of being flattened, as is commom with BPES.

>

> The surgery was about 3 1/2 hours long but she looked much better than I

> expected afterwards. There was some swelling at the bridge of the nose and

just

> two small incisions on each side of the nose by the inner corners and small

> incisions at the outer corners of the eyse that were sutured. She recovered

> well. The worst part was having the sutures removed. They can't use ones

that

> disolve because of the swelling. They ended up giving her a sedative and

> holding her down. Never again. After that, she's always been given

anesthesia for

> any suture removals.

>

> The transnasal wiring was very " tight " at first with very pointed corners.

> However, the surgeon thinks the sutures may have slipped and will make a

> decision later on as to if he wants to go back in and tighten them again.

>

> I have posted some pictures but will post one of her right after the

> transnasal wiring surgery.

>

> Patty

January 15, 2004

Hi Becki:

Sami was 3 when she had the transnasal wiring (Last April). That was the first surgery and she just had the sling surgery in October and is now 4yr old. Her MD never said anything about replacing the "meltable" plate but did say that as she develops, it should help the bridge become more prominent.

She sees Dr. Randall Beatty at the University of Pittsburgh Eye and Ear Institute. He has done the procedure before, not really sure how many times but was quite familiar with it. He did mention that after she has time to grow a bit more, he may need to go back and try to lengthen the openings from left to right. My husband, who also has BPES had the outer corners of his eyes cut but the appearance is not as natural as he would have liked and the surgeon said he would do it differently.

I'm glad I could help. I understand your anxieties, I really had them too. Sami did have some mild pain for a few days afterwards but it was controlled with just Tylenol. I also used frozen peas (yes the vegetable) in a bag as ice too. If you can get ice on in the first 24 hours, the less swelling he'll have. (A bit difficult though for the little ones.) It's truly amazing how resilient they are and recover much quicker than us.

Here is her MD's info:

Randall Beatty, MD

University of Pittsburgh Physicians

University Eye Car

Orbital and Oculoplastic Surgery

Eye and Ear Institute

203 Lothrop St., Suite 718

Pittsburgh, PA 15213

1-800-466-3797

Patty

January 15, 2004

I'm glad you found the pictures helpful. She's our happy girl and such a trooper. She's only had the two surgeries, but 4 others due to infections. Last week they removed the l;eft eye sling due to the infection but her MD said she developed scar tissue around the sling and it is now acting in its place. So far we cannot tell any difference and she is opening it as much as she did with the sling in. The MD said maybe she won't have to have it put back in. We are crossing our fingers.

Patty

January 17, 2004

bcrijns wrote:

> Wow these fishing weights sound so weird!

> Lets hope someone's out there who'll be able to explain the

> procedure.

> Bernice

Don't look at me, I'm just as perplexed. None of my journal papers

mention fishing tackle of any kind, but some of them describe the use of

canthal " buttons " or folded bits of tubing or some form of wadding or

whatever, used to apply pressure to the canthal area so that it binds

well to the underlying tissue and also heals flat. Perhaps that's what

the weights were for? But fishing weights are made of lead, aren't

they? Healthy, therapeutic lead. (Homer: " mmmmm.... lead... " ) It also

seems strange that they weren't sewn or stuck or padded in place

somehow. This makes me suspect that they might have been purely to stop

an inquisitive child from interfering with her dressings...

The thick plottens.

Rob

January 17, 2004

I think i'm going to have to call my mom and find out the exact story about

these fishing weights.