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Cranial flap

Ehab M Elzawawy, Melad N Kelada, Ahmed F Al Karmouty
Introduction. Submammary adipofascial flap (SMAF) is a valuable option for replacement of the inferior portion of the breast. It is particularly useful for reconstruction of partial mastectomy defects. It is also used to cover breast implants. Most surgeons base this flap cranially on the submammary skin crease, reflecting it back onto the breast. The blood vessels supplying this flap are not well defined, and the harvest of the flap may be compromised due to its uncertain vascularity. The aim of the work was to identify perforator vessels supplying SMAF and define their origin, site, diameter, and length...
2016: Anatomy Research International
Yoshiaki Sakamoto, Eric Arnaud
In cases of skull trauma, emergency surgery for cranial decompression typically involves the shortest approach, with the incision lying directly on or immediately near the bony defect. Subsequent reconstructive plastic surgery for the skull is difficult in such cases because incisions taken on the previous scar overlying the bony defect are prone to dehiscence and infection. Herein, we describe a technique for creating a well-vascularized delayed skin flap via multistaged operation before the actual skull reconstruction...
August 2016: Plastic and Reconstructive Surgery. Global Open
Raphael Carloni, Christian Herlin, Benoit Chaput, Antoine De Runz, E Watier, Nicolas Bertheuil
BACKGROUND: Resection of cranial tumors involving both bone and scalp tissue may require the recruitment of soft tissue using a flap above the bone reconstruction. When a transposition flap has been chosen, the alopecia zone on the donor site may be difficult to treat afterward. Scalp expansion is the gold standard in these situations, but this has never been described above cranial implants. We report the first case of a patient who underwent a scalp tissue expansion above a custom-made hydroxyapatite cranial implant to correct sequelar alopecia...
September 5, 2016: World Neurosurgery
Jan-Falco Wilbrand, Hans-Peter Howaldt, Marcus Reinges, Petros Christophis
OBJECTIVE: Premature craniosynostosis of the lambdoid suture is rare. The use of differential diagnosis to rule out positional occipital plagiocephaly is crucial. Nevertheless, once diagnosed, lambdoid craniosynostosis requires corrective surgery to prevent intracranial harm and aesthetic stigma by significant dyscrania. Operative correction of the lambdoid fusion is often performed by suturectomy and helmet therapy, total occipital remodeling interventions, transposition of occipital bone flaps, or occipital advancement procedures either with or without distraction osteogenesis...
August 6, 2016: Journal of Cranio-maxillo-facial Surgery
Kirsten E Stoner, Kingsley O Abode-Iyamah, Nicole M Grosland, Matthew A Howard
BACKGROUND: Decompressive craniectomy procedures are performed in patients with malignant intracranial hypertension. A bone flap is removed to relieve pressure. Later a second operation is performed to reconstruct the skull after brain swelling has resolved. This surgical treatment would be improved if it were possible to perform a single operation that decompressed the brain acutely while eliminating the need for a second operation. In order to design a device and procedure that achieves this objective it is essential to understand how the brain swells following a craniectomy procedure...
August 30, 2016: World Neurosurgery
Kate Miller, Sam Eljamel
INTRODUCTION: Therapeutic decompressive craniectomy (TDC) controls raised intracranial pressure (rICP). Its role remained controversial until its successful introduction to treat malignant middle cerebral artery ischemia. However, standardization of its size and site remain controversial points. This study was designed to evaluate does size and site matter in TDC? METHODS: We used a replica-skull of a patient with refractory rICP and successful TDC. ICP was raised using intracranial balloon modified to monitor ICP and permit progressive ICP-increments...
August 24, 2016: World Neurosurgery
Ali Ebrahimi, Nasrin Nejadsarvari, Hamid Reza Rasouli, Azin Ebrahimi
BACKGROUND: Anterior cranial bone defects secondary to global war cranial defects pose a unique reconstructive challenge. The objective of this study was to evaluate the outcomes of alloplastic reconstructions of cranial bone with titanium mesh and fat graft after warfare-related cranial trauma. PATIENTS AND METHODS: Thirty-five patients at the plastic and reconstructive surgery ward of our hospital underwent anterior cranioplasty with titanium mesh with or without fat grafts from lower abdominal wall...
January 2016: Annals of Maxillofacial Surgery
So Young Kim, Kyeong-Tae Lee, Goo-Hyun Mun
BACKGROUND: When using deep inferior epigastric artery perforator (DIEP) flaps in breast reconstruction, harvesting bipedicled flaps can be a valuable option in cases requiring the transfer of a large portion of harvested flaps. Connecting the bilateral deep inferior epigastric arteries (DIEAs) by intraflap crossover anastomosis is one of the most popular methods of constructing bipedicled DIEP flaps. Planning the primary and secondary pedicle configurations for reliable intraflap crossover anastomosis is crucial...
September 2016: Plastic and Reconstructive Surgery
Andrew P Murdoch, Sam N Greenaway, Laura J Owen, Alan Danielski
OBJECTIVES: To confirm the anatomic location of the cranial cutaneous branch of the saphenous artery (CCSA), delineate the angiosome of the CCSA, and provide guidelines for clinical use of an axial pattern flap based on the CCSA. STUDY DESIGN: Anatomic study. ANIMALS: Greyhound cadavers (n=10). METHODS: Shortly after euthanasia, the CCSA was identified and isolated in each hindlimb. Methylene blue and radiographic perfusion studies were performed...
October 2016: Veterinary Surgery: VS
Tom T Karnezis, Andrew B Baker, Zachary M Soler, Sarah K Wise, Shruthi K Rereddy, Zara M Patel, Nelson M Oyesiku, John M DelGaudio, Constantinos G Hadjipanayis, Bradford A Woodworth, Kristen O Riley, John Lee, Michael D Cusimano, Satish Govindaraj, Alkis Psaltis, Peter John Wormald, Steve Santoreneos, Raj Sindwani, Samuel Trosman, Janalee K Stokken, Troy D Woodard, Pablo F Recinos, W Alexander Vandergrift, Rodney J Schlosser
BACKGROUND: In patients undergoing transnasal endoscopic sellar surgery, an analysis of risk factors and predictors of intraoperative and postoperative cerebrospinal fluid leak (CSF) would provide important prognostic information. METHODS: A retrospective review of patients undergoing endoscopic sellar surgery for pituitary adenomas or craniopharyngiomas between 2002 and 2014 at 7 international centers was performed. Demographic, comorbidity, and tumor characteristics were evaluated to determine the associations between intraoperative and postoperative CSF leaks...
August 23, 2016: International Forum of Allergy & Rhinology
Ethan Bassett, Alexander Farag, Alfred Iloreta, Christopher Farrell, James Evans, Marc Rosen, Ameet Singh, Gurston Nyquist
BACKGROUND: The nasoseptal flap (NSF) is commonly used to repair skull base defects via a transnasal endoscopic approach. The original description of the technique includes 2 parallel incisions that follow the sagittal plane of the septum. We describe a novel modification to the traditional NSF that allows coverage along the posterior wall of the frontal sinus. METHODS: In addition to the 2 sagittal incisions, a third incision is made between these coursing along the maxillary crest from the posterior edge to the midportion of the flap...
August 22, 2016: International Forum of Allergy & Rhinology
L H Chen, Y Yang, Q Wei, Y J Li, W D Li, J B Gao, B Yu, H Zhao, R X Xu
OBJECTIVE: With the development of modern skull base minimally invasive technology mature and neural radio surgery techniques, it is necessary to re-examine the therapeutic strategy for the treatment of petroclival meningiomas. To sum up the operative experience and methods in microsurgical resection of petroclival meningiomas by the combining trans-subtemporal and suboccipital retrosigmoid keyhole approach. To explore the minimally invasive operation approach of petroclival meningiomas, to raise the removal degree and to improve the postoperative result using this approach...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Raghav Gupta, Nimer Adeeb, Christoph J Griessenauer, Justin M Moore, Apar S Patel, Ajith J Thomas, Christopher S Ogilvy
INTRODUCTION: Titanium fixation plates are routinely used for rigid fixation of bone flaps after craniotomy. In craniofacial surgery or after craniotomy involving orbitozygomatic osteotomies, these plates are occasionally removed because of infection, pain, protrusion, soft tissue erosion, and plate malfunction. However, plate removal because of pain and protrusion after craniotomy without orbitozygomatic osteotomy has rarely been reported. METHODS: A retrospective analysis of all patients who underwent removal of cranial fixation plates after craniotomy, performed by the senior authors at one institution between 2014 and 2016, was conducted...
October 2016: Acta Neurochirurgica
Cláudia Andrade, Fabrice Narducci, Lucie Bresson, Eric Leblanc
OBJECTIVE: Demonstration of surgical steps of a Boari Flap ureteroneocystostomy in an oncological context. METHODS: Clinical case of a 66-year-old woman diagnosed with a left-pelvic recurrence of a high-grade serous ovarian carcinoma, involving the left ureter. After transection of 5cm of ureteral length, up to the level of the bifurcation of common iliac vessels, it was decided to perform a Boari Flap for ureteral reimplantation. RESULTS: Through the tubularization of a bladder flap, the extension of the ureter to the bladder is possible...
October 2016: Gynecologic Oncology
Yu-Ching Feng, Kuan-Sheng Chen, Shih-Chieh Chang
This animal was presented with a large-sized infiltrative lipoma in the abdominal wall that had been noted for 4 years. This lipoma was confirmed by histological examination from a previous biopsy, and the infiltrative features were identified by a computerized tomography scan. The surgical removal created a large-sized abdominal defect that was closed by a combination of latissimus dorsi and external abdominal oblique muscle flaps in a pedicle pattern. A small dehiscence at the most distal end of the muscle flap resulted in a small-sized abdominal hernia and was repaired with cranial sartorius muscle flap 14 days after surgery...
July 29, 2016: Journal of Veterinary Medical Science
Brian T Andrews, Anna Lydick, Scott Barbay, Peter Reisz, Randolph J Nudo
BACKGROUND: Hemi-craniectomy is a common surgical procedure which allows the brain to swell and herniate and is often utilized to treat traumatic brain injury. When left untreated the scalp skin typically sinks on the side of the craniectomy creating a phenotype termed "sinking skin flap syndrome." In addition, these same patients often develop long-term neurocognitive deficits termed "syndrome of the trephined" as a result of their craniectomy which reverse when the cranial skull is replaced...
October 2016: Journal of Craniofacial Surgery
Ichiro Takumi, Masataka Akimoto, Akio Morita
We report on a new technical method of using an inverted and segmented galea-calvarial flap for simultaneous reconstruction of the frontal sinus and forehead. A 73-year-old man presented with the production of pus at the forehead, in which the frontal sinus had been involved 6 years postoperatively. The patient underwent surgery with our new simultaneous technique. During the 7 years of follow-up after this reconstructive surgery, no recurrence of surgical wound problems was noted.
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Mazda K Turel, Christopher J Chin, Allan D Vescan, Fred Gentili
With the use and efficacy of the vascularized nasoseptal flap, its indications are also expanding. Due to its relative ease of harvesting and no significant impairment in the long-term sinonasal quality of life, the flap has been used for a number of other purposes apart from its originally proposed use in reconstruction of the anterior cranial fossa, sella, and the clivus. Its use may negate the need of another incision to obtain fat or fascia. The authors describe the case of a 47-year-old lady who underwent endoscopic excision of a medially placed orbital intraconal hemangioma who presented to us with very poor vision in the left eye...
September 2016: Journal of Craniofacial Surgery
Han-Song Sheng, Nu Zhang, Jian Lin, Fen-Chun Lin, Bo Yin, Mao-de Wang
OBJECTIVES: Surgical management of cranial burst fracture (CBF) usually involves craniotomy to remove the devitalized brain tissues, followed by watertight repair of dural tears. However, there were times when the dural tear was so extensive that a substantially large bone flap would have to be removed in order to expose the retracted dural margins before it could be repaired. In such cases, strict dural repair would incur a significantly higher risk of damages to the surrounding neural tissues and severe bleeding, especially when the fracture was in the vicinity of eloquent cortical areas and sinus...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Cengizhan Ekizceli, Erdem Güven, Emre Hocaoğlu, Erol Kozanoğlu, Samet Vasfi Kuvat
No abstract text is available yet for this article.
September 2016: Journal of Craniofacial Surgery
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