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https://www.readbyqxmd.com/read/26761624/bone-flap-resorption-following-cranioplasty-in-a-cost-constrained-scenario
#1
Prasad Krishnan, Asis Kumar Bhattacharyya
Bone flap resorption is an infrequently reported yet significant late complication of autologous bone cranioplasty. It requires serial imaging both to pick up and to monitor progression. Custom-made implants avoid this complication, but are expensive. In a resource-limited situation, when bone flaps placed in the abdomen undergo demineralisation and sutures are used to fix the flap as opposed to plates, where artificial cranial flap substitutes are prohibitively expensive and frequent postoperative imaging may not be feasible, prevention and management of this complication will continue to remain a problem...
2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/26745194/use-of-adipose-derived-mesenchymal-stem-cells-to-accelerate-neovascularization-in-interpolation-flaps
#2
COMPARATIVE STUDY
Hakki Hayrettin Izmirli, Murat Sahin Alagoz, Huseyin Gercek, Guler Gamze Eren, Ergin Yucel, Cansu Subasi, Serkan Isgoren, Bahar Muezzinoglu, Erdal Karaoz
OBJECTIVE: Interpolation flaps are commonly used in plastic surgery to cover wide and deep defects. The need to, wait for 2 to 3 weeks until the division of the pedicle still, however, poses a serious challenge, not only extending treatment and hospital stay, but also increasing hospital expenses. To solve this problem, we have aimed to use the angiogenic potential of stem cells to selectively accelerate neovascularization with a view to increasing the viability of interpolation flaps and achieving early pedicle removal...
January 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/26513097/die-modifizierte-subkutan-gestielte-lappenplastik-modified-subcutaneously-pedicled-flap
#3
Josef Koller, Arno Hintersteininger, Karin Brugger-Jentsch
The subcutaneously pedicled flap, also known as V-Y flap, belongs to the group of island flaps whose blood supply (unlike the horizontally perfused advancement and transposition flaps) comes from subcutaneous blood vessels perpendicular to the skin surface. Because of the outstanding perfusion of this type of flap, we remove up to one-third of the cranial flap pedicle to form a skin flap (3-4 mm thick), resulting in a significant increase in the defect size able to be covered by the V-Y flap. Moreover, in the infraorbital region - as far as topographically feasible - this flap is pulled further cranially (in the direction of the defect to be closed) by an obliquely placed periosteal suture...
November 2015: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/26513096/modified-subcutaneously-pedicled-flap
#4
Josef Koller, Arno Hintersteininger, Karin Brugger-Jentsch
The subcutaneously pedicled flap, also known as V-Y flap, belongs to the group of island flaps whose blood supply (unlike the horizontally perfused advancement and transposition flaps) comes from subcutaneous blood vessels perpendicular to the skin surface. Because of the outstanding perfusion of this type of flap, we remove up to one-third of the cranial flap pedicle to form a skin flap (3-4 mm thick), resulting in a significant increase in the defect size able to be covered by the V-Y flap. Moreover, in the infraorbital region - as far as topographically feasible - this flap is pulled further cranially (in the direction of the defect to be closed) by an obliquely placed periosteal suture...
November 2015: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/26171578/the-recent-revolution-in-the-design-and-manufacture-of-cranial-implants-modern-advancements-and-future-directions
#5
REVIEW
David J Bonda, Sunil Manjila, Warren R Selman, David Dean
Large format (i.e., >25 cm) cranioplasty is a challenging procedure not only from a cosmesis standpoint, but also in terms of ensuring that the patient's brain will be well-protected from direct trauma. Until recently, when a patient's own cranial flap was unavailable, these goals were unattainable. Recent advances in implant computer-aided design and 3-dimensional (3-D) printing are leveraging other advances in regenerative medicine. It is now possible to 3-D-print patient-specific implants from a variety of polymer, ceramic, or metal components...
November 2015: Neurosurgery
https://www.readbyqxmd.com/read/24280540/harvesting-free-abdominal-perforator-flaps-in-the-presence-of-previous-upper-abdominal-scars
#6
Moustapha Hamdi, Mikko Larsen, Barbara Craggs, Bert Vanmierlo, Assaf Zeltzer
PURPOSE: Subcostal scars pose a risk of upper abdominal flap ischaemia when raising a free abdominal flap. The aim of this study was to describe a clinical approach to increase flap reliability and donor site healing in the presence of transverse abdominal scars while harvesting lower abdominal free flaps. METHODS: A total of 11 patients who had subcostal scars and one who had an extended subcostal scar (rooftop or chevron incision) underwent free abdominal flaps for breast reconstruction...
February 2014: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/24108242/accuracy-of-frame-based-stereotactic-depth-electrode-implantation-during-craniotomy-for-subdural-grid-placement
#7
Charles N Munyon, Mohamad Z Koubeissi, Tanvir U Syed, Hans O Lüders, Jonathan P Miller
BACKGROUND: Frame-based stereotaxy and open craniotomy may seem mutually exclusive, but invasive electrophysiological monitoring can require broad sampling of the cortex and precise targeting of deeper structures. OBJECTIVES: The purpose of this study is to describe simultaneous frame-based insertion of depth electrodes and craniotomy for placement of subdural grids through a single surgical field and to determine the accuracy of depth electrodes placed using this technique...
2013: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/19844617/medpor-craniotomy-gap-wedge-designed-to-fill-small-bone-defects-along-cranial-bone-flap
#8
Duck-Ho Goh, Gyoung-Ju Kim, Jaechan Park
OBJECTIVE: Medpor porous polyethylene was used to reconstruct small bone defects (gaps and burr holes) along a craniotomy bone flap. The feasibility and cosmetic results were evaluated. METHODS: Medpor Craniotomy Gap Wedges, V and T, were designed. The V implant is a 10 cm-long wedge strip, the cross section of which is an isosceles triangle with a 4 mm-long base, making it suitable for gaps less than 4 mm after trimming. Meanwhile, the Medpor T wedge includes a 10 mm-wide thin plate on the top surface of the Medpor V Wedge, making it suitable for gaps wider than 4 mm and burr holes...
September 2009: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/19398224/post-traumatic-fronto-ethmoid-osteomyelitis-treated-with-free-muscle-transfer
#9
Yu-Te Lin, Chien-Tzung Chen, Jui-Ping Lai
Intractable frontal sinus infection after obliteration of the injured sinus and nasofrontal duct has become a less common injury nowadays. Adequate debridement complemented with a viable peri-cranial flap would usually prevent the troublesome frontal sinusitis. Nonetheless if recurrent infection involves both the frontal and ethmoid sinuses, local tissues may not suffice for obliteration of the dead space. We developed the use of a free vascularised muscle flap that may be the best option in treating osteomyelitic sinusitis...
June 2010: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/19027382/a-study-of-fractured-cranial-flap-refixation
#10
COMPARATIVE STUDY
Yang Shu-xu, Su Zhi-peng, He Zhang, Wang Yi-rong, Zeng Yanjun
OBJECTIVE: To study the techniques of fractured cranial flap refixation (suture, wire and titanium clamps). METHODS: Twenty-four cadaver craniotomy flaps, sawn as fractured flap models, were divided into three groups, and every eight fractured flaps were reattached with sutures, wires and titanium clamps, respectively. Bone flap refixation was timed and measured for offset. For every fixation technique, load-bearing tests were performed on craniotomied skulls by applying an external force until the refixation system failed...
November 2009: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/17530197/-open-posterior-inferior-capsule-shift-for-the-treatment-of-atraumatic-posterior-shoulder-instability
#11
REVIEW
Thomas Ambacher, Ulrich Holz
OBJECTIVE: Restoration of functional stability and full range of shoulder mobility. INDICATIONS: Atraumatic, recurrent posterior dislocation or subluxation in cases of excessive posterior joint capsular volume without clinically relevant destruction of the glenoid or dysplasia. Additional procedure for traumatic posterior instability after reattachment of the labrum or screw fixation of the posterior glenoid fragment. CONTRAINDICATIONS: Capsular shift should not be an isolated procedure in glenoid hypoplasia and/or glenoid retroversion > 15 degrees (relative)...
June 2007: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/17413880/biomechanical-evaluation-of-cranial-flap-fixation-techniques-comparative-experimental-study-of-suture-stainless-steel-wire-and-rivetlike-titanium-clamp
#12
COMPARATIVE STUDY
Yi Rong Wang, Zhi Peng Su, Shu Xu Yang, Bi Yun Guo, Yan Jun Zeng
OBJECTIVE: To study the techniques of cranial flap fixation (suture, stainless steel wire, and rivetlike titanium clamp) on biomechanics. METHODS: Twenty-four cadaver craniotomy flaps were reattached with either suture, stainless steel wire, or rivetlike titanium clamp. Cranial flap fixation was timed and measured for the offset between cranial flap with craniotomy skull for every fixation technique. Load-bearing tests were performed by applying an external force until the failure of the fixation system...
April 2007: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/17171103/experience-with-24-cases-of-reconstructive-anterior-skull-base-surgery-classification-and-evaluation-of-postoperative-facial-appearance
#13
Y Yamamoto, H Minakawa, K Kawashima, T Sugihara, S Fukuda, Y Sawamura, A Watanabe, K Nohira
This article details our experience with 24 cases of anterior skull base reconstruction after tumor resection. They were classified into four types according to the resected region. In 11 cases of type I resection, the orbital part of frontal bone and/or cribriform plate of ethmoid bone were resected. In two cases of type II resection, the orbital contents and partial orbital bone were resected with the addition of type I. In five cases of type III resection, the maxillary bone was resected with the addition of type II...
2000: Skull Base Surgery
https://www.readbyqxmd.com/read/16803916/case-series-monocular-visual-loss-associated-with-subarachnoid-hemorrhage-secondary-to-ruptured-intracranial-aneurysms
#14
Chin Ted Chong, Ki Jinn Chin, Leonard W Yip, Kulgit Singh
PURPOSE: To describe variations in the presentation of monocular visual loss associated with intracranial aneurysm rupture. The clinical course, possible etiologies and management of visual loss in three patients are described. CLINICAL FEATURES: The first patient developed Terson's syndrome (vitreal hemorrhage associated with raised intracranial pressure secondary to subarachnoid hemorrhage). Following aneursymal clipping, her postoperative management was conservative and there was no improvement in visual acuity...
July 2006: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/12959434/cranial-bone-fixation-review-of-the-literature-and-description-of-a-new-procedure
#15
REVIEW
Ken R Winston, Marjorie C Wang
OBJECT: Fixation of cranial bone flaps should be reliable, safe, rapid, esthetically acceptable, and inexpensive. It should require minimal foreign material, and ideally it should produce no artifacts on neuroimaging. The authors describe a new procedure that meets these criteria. METHODS: In this procedure, the cranial bone flap is affixed by tightly packing into the surrounding kerf the shims of bone that are harvested from the under edge of the free bone flap and then securing the flap with absorbable sutures...
September 2003: Journal of Neurosurgery
https://www.readbyqxmd.com/read/11314381/surgical-treatment-of-frontoethmoidal-encephalocele-a-case-report
#16
F S De Ponte, M Pascali, M Perugini, A Lattanzi, P Gennaro, A Brunelli
This study reports a patient affected by congenital frontoethmoidal encephalocele. The cause of this malformation is unknown. A preoperative selective diagnosis evaluation is necessary. The workup should include an accurate clinical examination associated with radiological study (two- and three-dimensional computed tomography, magnetic resonance imaging, etc). The aim of the surgical treatment is to restore the functional brain tissue in the cranial cavity, perform dural repair, correct bone lack and other associated facial malformations (hypertelorism, orbital dystopia, etc...
July 2000: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/11121312/a-new-operative-method-of-correcting-cryptotia-using-large-z-plasty
#17
T Yotsuyanagi, K Yamashita, Y Shinmyo, K Yokoi, Y Sawada
A large Z-plasty on the postauricular surface of the ear has been used for successful reconstruction of cryptotia. This technique provides extensive skin coverage of the posterior auricle without skin grafting. The technique is easy and simple. The natural hairline is not disturbed and the temporoauricular sulcus is emphasised. Almost all of the scar is hidden behind the auricle. It has been performed on 17 patients with no recurrence of the cryptotia. One patient had partial congestion in the cranial-flap tip, which improved within 1 week...
January 2001: British Journal of Plastic Surgery
https://www.readbyqxmd.com/read/10481445/the-suture-applicator-for-replacing-a-bone-flap-technical-note
#18
S Kondo, A Kobayashi, H Nagata
A new instrument was developed for passing and holding sutures during the replacement of a bone flap. The new device is a simple straight aluminum shaft, 6 cm in length and 0.7 mm in diameter with a groove on both ends for holding the suture. The shaft can be easily bent with the fingers to attain the desired curve and more suitable manipulation. Passing the shaft through the straight hole in the cranium or the cranial flap was very easy and convenient. No dural damage occurred during 80 procedures using this shaft...
May 1999: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/10201321/reliability-of-cranial-flap-fixation-techniques-comparative-experimental-evaluation-of-suturing-titanium-miniplates-and-a-new-rivet-like-titanium-clamp-craniofix-technical-note
#19
K D Lerch
OBJECTIVE: To ensure patients' safety, the mechanical strength of cranial flap refixation techniques and implants (sutures, titanium miniplates, and new rivet-like titanium clamps) had to be validated. METHODS: With craniotomied cadaver skulls for each refixation technique, load-bearing tests were performed by applying an external force until an impression depth of the cranial flap of 2 mm was reached and the results were compared. RESULTS: CranioFix (Aesculap AG, Tuttlingen, Germany) and miniplates were revealed to be the strongest fixation devices, although with miniplates, the plastic deformation started from the beginning of load application, whereas CranioFix additionally provided a better spring-elastic reserve and a higher reproducibility of fixation strength not dependent on bone thickness and consistency...
April 1999: Neurosurgery
https://www.readbyqxmd.com/read/9852168/primary-reconstruction-of-the-ala-nasi-in-cleft-lip
#20
A M Fontana, E Muti
Displacement of the lateral crus of the alar cartilage of the nose in cleft lip is demonstrable in diagrams showing the pathological anatomy of this deformity. An account is given of our method used for several years, whereby the lateral limb is returned to a more natural position, alar convexity is restored, and the angle between the limbs is corrected. Two flaps taken from the inside surface of the nostril are alternated. The caudal one is a full-thickness flap composed of vestibular skin, while the cranial flap comprises the cartilage and the vestibular mucosa; the lateral limb is left attached to the mucosa...
November 1998: Aesthetic Plastic Surgery
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