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Cranial flap

Stephen Honeybul, David Anthony Morrison, Kwok M Ho, Christopher R P Lind, Elizabeth Geelhoed
OBJECTIVE: To compare the long-term outcomes of patients who had been randomly allocated to receive primary titanium cranioplasty or autologous bone graft following decompressive craniectomy. METHODS: Sixty-four patients had been previously enrolled and randomised to receive either their own bone graft or a primary titanium cranioplasty. Functional and cosmetic outcomes had previously been assessed at 1-year following the cranioplasty procedure. Hospital records and the Picture Archiving communication system were reviewed to determine how many patients had cranioplasty failure or associated complications such as seizures beyond 1 year-with a minimum of 24-month follow-up...
March 15, 2018: Acta Neurochirurgica
Sheng Yan, Hangyan Shi, Da Chen, Jincai Guo, Yi Sun, Sufan Wu
The reconstruction of large full-thickness scalp defects remains a surgical challenge, especially when the skull is exposed completely without periosteum. Surgical technique options for wound coverage have included tissue expansion, skin grafting, local or regional flaps, and microvascular free tissue transfer. In recent years, some authors have reported to use biological material as an alternative for repairing complex wounds. The authors report the successful reconstruction of a large defect with bare skull in bilateral temporal regions of a 3-year-old child...
March 14, 2018: Journal of Craniofacial Surgery
Ramón Medel Jiménez, Juan C Sánchez España, José Visa Nassarre, Eva Ayala Barroso, Alfredo Pueyo Ferrer, Alejandra Tapia Bahamondes, Luz M Vasquez
PURPOSE: To describe our experience and outcomes managing complete third cranial nerve palsy. METHODS: This was a retrospective analysis of the clinical records of 7 consecutive patients treated at our centre for unilateral third nerve palsy over the period 2010-2016. We describe our surgical approach using a frontalis muscle flap to correct the eyelid ptosis associated with medial fixation of the rectus muscle tendon to the orbit to correct the horizontal deviation...
March 15, 2018: Orbit
Dorothee Boehm, Konstantin Bergmeister, Emre Gazyakan, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
AIMS: Reconstruction of breasts and chest wall deformities in female patients after severe burn injury is a challenge for reconstructive surgeons. In these patients, neither implant-based procedures nor standard free flaps are sometimes applicable because of limited skin quality and unavailability of donor sites at the abdomen, back, buttock, or medial thigh. METHODS: We present a case of a young female patient with a history of 80 % total body surface area burn after electric high-voltage injury...
March 13, 2018: Annals of Plastic Surgery
S Bastaninejad, E Karimi, N Saeedi, E Amirizad
Despite progress made in nasal reconstruction, the restoration of a large defect, including the whole septum and mid-nasal vault structures, remains a challenge. The pericranial flap (PCF) is used widely for the reconstruction of anterior cranial fossa defects. This article presents a surgical technique for nasal lining restoration with an endoscopic PCF design. This technique was used in patients with huge intranasal tumours. Two patients with nasal eosinophilic angiocentric fibrosis were treated. The structural involvement was similar in each case...
March 8, 2018: International Journal of Oral and Maxillofacial Surgery
Hakan Kerem, Ulaş Bali, Erhan Sönmez, Mustafa Kürşat Evrenos
Background: Cranially-based nasolabial flaps are a good alternative for the reconstruction of nasal defects. Methods: A cranially-based nasolabial flap was used in 18 patients to reconstruct defects of the nose from 2010 to 2016, and the long-term results are presented in this report. Results: Fifteen of the flaps completely survived. All the patients had a bulky appearance, but they did not want to undergo a second operation for cosmesis...
March 5, 2018: Archives of Plastic Surgery
Kazuyuki Kubo, Hiroyuki Takei, Atsumori Hamahata, Hiroshi Matsumoto, Hiroyuki Sakurai
PURPOSE: To prevent tissue expander (TE) exposure following mastectomy flap necrosis in immediate breast reconstruction, the TE is usually covered completely or partially with a musculofascial (MF) flap. This study compares the complications of the two coverage methods. METHODS: We reviewed, retrospectively, 106 cases of immediate TE-based breast reconstruction. The patients were divided into two groups according to whether complete or partial TE coverage was done...
March 5, 2018: Surgery Today
Yiyuan Li, Chunxiao Cui, Ruhong Zhang, Qun Zhang, Zhicheng Xu, Feng Xu, Datao Li
OBJECTIVES: The retroauricular fascia flap (RFF) is one of the most commonly used vascularized linings for auriculocephalic sulcus reconstruction in staged total auricular reconstruction. This study aims to investigate the histomorphometric features regarding the retroauricular fascia. METHODS: Histological evaluation included qualitative observation and quantitative analysis of sections of RFF stained with hematoxylin and eosin, Masson's trichrome, Elastica van Gieson, CD31, and Lyve-1...
February 22, 2018: Aesthetic Plastic Surgery
Jingyi Zhao, Guodong Song, Xianlei Zong, Xiaonan Yang, Le Du, Xiaoshuang Guo, Chenzhi Lai, Zuoliang Qi, Xiaolei Jin
BACKGROUND: Skin ulcers and alloplastic implant exposure are intractable complications that arise after cranial defect reconstruction. Many methods have been used to repair these defects, including skin grafting, local flaps, and free flaps; however, in most cases, alloplastic implants must be removed to control infections. Here, we describe the use of a reversed temporal island flap to repair exposed titanium mesh without removing it. METHODS: Eight cases of skin and titanium mesh exposure were included from 2010 to 2015...
January 29, 2018: World Neurosurgery
Keyin Liu, Zhifeng Shi, Shaoqing Zhang, Zhitao Zhou, Long Sun, Tao Xu, Yeshun Zhang, Guozheng Zhang, Xinxin Li, Liang Chen, Ying Mao, Tiger H Tao
Cranial fixation should be safe, reliable, ideally degradable, and produce no hazardous residues and no artifacts on neuroimaging. Protein-based fixation devices offer an exciting opportunity for this application. Here, the preclinical development and in vivo efficacy verification of a silk cranial fixation system in functional models are reported by addressing key challenges toward clinical use. A comprehensive study on this fixation system in rodent and canine animal models for up to 12 months is carried out...
January 26, 2018: Advanced Healthcare Materials
Patrick J Buchanan, Danielle C Mihora, Bruce A Mast
BACKGROUND: Facial rejuvenation is an elective procedure commonly performed to combat the consequences of normal aging. The senior author's practice initially consisted of traditional facelifts with superficial muscular apopneurotic system plication and/or superficial muscular apopneurotic system flap. After the development of the minimal access cranial suspension (MACS) technique by Tonnard et al., the senior author transitioned to an almost exclusive MACS facelift practice. The purpose of this study was to determine the efficacy of the MACS technique versus the traditional facelift approach and objectively incorporate these results into practice...
January 24, 2018: Annals of Plastic Surgery
Takafumi Togashi, Hironori Baba, Meiko Kitazawa, Nao Takahashi, Yasuhiro Samejima, Eiji Yumoto, Arata Horii
Cluster of acute flaccid paralysis and cranial nerve dysfunction was associated with a 2014 outbreak of enterovirus D68 (EV-D68) respiratory illness in US. We describe a 33 year-old male patient of refractory dysphagia due to EV-D68-induced brainstem encephalitis successfully treated by surgery. Following acute upper respiratory tract infection, he developed dysphagia and bilateral facial paralysis. A coughing reflex was readily produced when the laryngopharyngeal fiberscope touched the epiglottis, however, water infusion induced only very weak and slow swallowing reflex, suggesting that only motor component was impaired but sensory function was preserved during swallowing...
January 20, 2018: Auris, Nasus, Larynx
Jonathan Russin, Joseph Carey
BACKGROUND: Free flaps are commonly used by other surgical subspecialties for soft tissue reconstruction and revascularization. Cranial applications of these flaps have been limited to only a single case report. OBJECTIVE: To present a new technique for combined revascularization in moyamoya disease using a flow-through free flap. METHODS: Data were obtained from an Institutional Review Board-approved, prospectively maintained database with informed consent from the patient...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Yuichiro Yoneoka, Katsuhiko Akiyama, Yasuhiro Seki, Go Hasegawa, Akiyoshi Kakita
BACKGROUND: Frontoethmoidal schwannomas are rare. No case manifesting exertional cerebrospinal fluid (CSF) rhinorrhea has ever been reported to the best of our knowledge. CASE DESCRIPTION: In this report, we describe an extremely rare case of frontoethmoidal schwannoma extending through the olfactory groove (OG) with exertional CSF rhinorrhea as the initial symptom. A 50-year-old woman was presented to our clinic for frequent nasal discharge on exertion. A postcontrast computed tomographic scan demonstrated heterogeneously enhanced tumor from the anterior cranial fossa to the anterior ethmoid sinus...
January 9, 2018: World Neurosurgery
Camille Bismuth, Claire Deroy
Case summary: Cranial ventral midline hernias, most often congenital, can be associated with other congenital abnormalities, such as sternal, diaphragmatic or cardiac malformations. A 4-year-old multiparous queen with a substernal hernia was admitted for evaluation of a mammary mass. During CT examination, a bifid sternum, the abdominal hernia containing the intestines, spleen, omentum, three fetuses, a mammary mass and an incidental peritoneopericardial diaphragmatic hernia were identified...
July 2017: JFMS Open Reports
Sarina K Mueller, George Scangas, Mansor M Amiji, Benjamin S Bleier
BACKGROUND: No high-fidelity animal model exists to examine prospective wound healing following vascularized reconstruction of the skull base. Such a model would require the ability to study the prospective behavior of vascularized mucosal repairs of large dural and arachnoid defects within the intranasal environment. The objective of this study was to therefore develop and validate a novel, in vivo, transfrontal sheep model of cranial base repair using vascularized sinonasal mucosa. METHODS: Twelve transfrontal craniotomy and 1...
December 11, 2017: International Forum of Allergy & Rhinology
Alexander W Murphey, William B Clinkscales, Samuel L Oyer
Importance: A review of the role of masseteric nerve transfer is needed to guide its use in facial reanimation. Objective: To systematically review the available literature, and, when applicable, analyze the combined outcomes of masseteric nerve transfer to better define its role in reanimation and to guide further research. Data Sources: Two independent researchers conducted the review using PubMed-NCBI and Scopus literature databases for studies on masseteric nerve transfer for facial nerve paralysis...
December 7, 2017: JAMA Facial Plastic Surgery
Dominic Anto, Raju Paul Manjooran, Rajeev Aravindakshan, Kumar Lakshman, Raymond Morris
Context: Decompressive craniectomy followed by cranioplasty (CP) uses autologous craniectomy flaps or synthetic materials like titanium. Sterilization and preservation methods for the autologous bone flaps continue to be the surgeon's choice. Aim: This study aimed to assess the short-term as well as long-term clinical outcomes of CP using autoclaved autologous bone grafts. Settings and Design: This retrospective observational study was performed on patients admitted in a tertiary care teaching neurosurgery department...
October 2017: Journal of Neurosciences in Rural Practice
S S Prodanov, E G Benkova, A A Chokoeva
Electrical burns are group of traumatic injuries with a mortality rate of 3-15%. High-voltage induced extensive electric burns are rarely seen in the cranial area, compared to upper and lower limbs, but extremely difficult for treatment, due to the limited flexibility in this area. The spectrum of therapeutic interventions in electrical burns in general, evolving initial necrectomy, decompression, and aggressive debridement with early skin coverage is usually not enough in cases of extensive cranial defects...
November 28, 2017: Dermatologic Therapy
Allison Bethune, Nadia Scantlebury, Ekaterina Potapova, Nicole Dinn, Victor Yang, Todd Mainprize, Mahmood Fazl, Farhad Pirouzmand, Leodante da Costa, Martin Chapman, Nicolas Phan
Somatosensory evoked potentials (SSEPs) are used for neuroprognosis after severe traumatic brain injury (TBI). However decompressive craniectomy (DC), involving removal of a portion of the skull to alleviate elevated intracranial pressure, is associated with an increase in SSEP amplitude. Accordingly, SSEPs are not available for neuroprognosis over the hemisphere with DC. We aim to determine the degree to which SSEP amplitudes are increased in the absence of cranial bone. This will serve as a precursor for translation to clinically prognostic ranges...
November 30, 2017: Journal of Clinical Monitoring and Computing
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