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Cranial flap

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https://www.readbyqxmd.com/read/29775983/classification-and-microvascular-flap-selection-for-anterior-cranial-fossa-reconstruction
#1
James D Vargo, Wojciech Przylecki, Paul J Camarata, Brian T Andrews
BACKGROUND:  Microvascular reconstruction of the anterior cranial fossa (ACF) creates difficult challenges. Reconstructive goals and flap selection vary based on the defect location within the ACF. This study evaluates the feasibility and reliability of free tissue transfer for salvage reconstruction of low, middle, and high ACF defects. METHODS:  A retrospective review was performed. Reconstructions were anatomically classified as low (anterior skull base), middle (frontal bar/sinus), and high (frontal bone/soft tissue)...
May 18, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29758368/infections-following-cranial-neurosurgery-prospective-cohort-of-103-episodes-treated-according-to-a-standardized-algorithm
#2
Nora Renz, Burcin Özdirik, Tobias Finger, Peter Vajkoczy, Andrej Trampuz
OBJECTIVE: The optimal surgical and antimicrobial treatment for intracranial infections following neurosurgery is unknown. We investigated the clinical, laboratory and microbiological characteristics of intracranial infections following neurosurgery. In addition, treatment outcome in patients treated according to a standardized algorithm was evaluated. METHODS: Consecutive patients with extradural, intradural and device-related infections following cranial neurosurgery were prospectively included...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29755851/a-comparison-of-three-methods-for-the-analysis-of-skin-flap-viability-reliability-and-validity
#3
Carla Roberta Tim, Cintia Cristina Santi Martignago, Viviane Ribeiro da Silva, Estefany Camila Bonfim Dos Santos, Fabiana Nascimento Vieira, Nivaldo Antonio Parizotto, Richard Eloin Liebano
Objective: Technological advances have provided new alternatives to the analysis of skin flap viability in animal models; however, the interrater validity and reliability of these techniques have yet to be analyzed. The present study aimed to evaluate the interrater validity and reliability of three different methods: weight of paper template (WPT), paper template area (PTA), and photographic analysis. Approach: Sixteen male Wistar rats had their cranially based dorsal skin flap elevated. On the seventh postoperative day, the viable tissue area and the necrotic area of the skin flap were recorded using the paper template method and photo image...
May 1, 2018: Advances in Wound Care
https://www.readbyqxmd.com/read/29749908/predictors-of-primary-autograft-cranioplasty-survival-and-resorption-after-craniectomy
#4
Tommi K Korhonen, Sami Tetri, Jukka Huttunen, Antti Lindgren, Jaakko M Piitulainen, Willy Serlo, Pekka K Vallittu, Jussi P Posti
OBJECTIVE Craniectomy is a common neurosurgical procedure that reduces intracranial pressure, but survival necessitates cranioplasty at a later stage, after recovery from the primary insult. Complications such as infection and resorption of the autologous bone flap are common. The risk factors for complications and subsequent bone flap removal are unclear. The aim of this multicenter, retrospective study was to evaluate the factors affecting the outcome of primary autologous cranioplasty, with special emphasis on bone flap resorption...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29716722/multi-view-stereo-in-the-operating-room-allows-prediction-of-healing-complications-in-a-patient-specific-model-of-reconstructive-surgery
#5
Taeksang Lee, Sergey Y Turin, Arun K Gosain, Adrian Buganza Tepole
Excessive mechanical stress leads to wound healing complications following reconstructive surgery. However, this knowledge is not easily applicable in clinical scenarios due to the difficulty in measuring stress contours during complex tissue rearrangement procedures. Computational tools have been proposed as an alternative to address this need, but obtaining patient specific geometries with an affordable and flexible setup has remained a challenge. Here we present a methodology to determine the stress contours from a reconstructive procedure on a patient-specific finite element model based on multi-view stereo (MVS)...
April 22, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29716176/temporal-augmentation-with-calvarial-onlay-graft-during-pterional-craniotomy-for-prevention-of-temporal-hollowing
#6
Ji Hyun Kim, Ryun Lee, Chi Ho Shin, Han Kyu Kim, Yea Sik Han
Background: Atrophy of muscle and fat often contributes to temporal hollowing after pterional craniotomy. However, the main cause is from the bony defect. Several methods to prevent temporal hollowing have been introduced, all with specific limitations. Autologous bone grafts are most ideal for cranial defect reconstruction. The authors investigated the effectiveness of bony defect coverage and temporal augmentation using pterional craniotomy bone flap. Methods: This study was conducted in 100 patients who underwent brain tumor excision through pterional approach from 2015 to 2016...
April 28, 2018: Archives of Craniofacial Surgery
https://www.readbyqxmd.com/read/29705732/treatment-and-reconstruction-of-a-complicated-infected-scalp-squamous-cell-carcinoma-with-cns-invasion
#7
Andreas Nørgaard Glud, Frantz Rom Poulsen, Jane Linnet, Jens Ahm Sørensen
A 60-year-old male patient with a large infected cranial apex lesion was admitted with lethargy and mental status changes. The patient underwent evaluation with imaging studies, a skin biopsy, cultures with microscopy and a diagnostic burr hole. MRI and positron emission tomography/CT scan revealed a squamous cell carcinoma with ingrowth in the midline of the brain and subdural empyema infected with Streptococcus anginosus and Staphylococcus aureus High dose intravenous antibiotic treatment was initiated and the patient subsequently underwent a surgical resection of the carcinoma with a 1 cm margin of surrounding skin and skull...
April 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29688445/extrapolating-the-limits-of-the-nasoseptal-flap-with-pedicle-dissection-to-the-internal-maxillary-artery
#8
Carlos D Pinheiro-Neto, Maria Peris-Celda, Tyler Kenning
BACKGROUND: The nasoseptal flap is the main pedicled flap used for endoscopic cranial base reconstruction. For large anterior cranial base defects, the anterior edge is a concern for the nasoseptal flap reach. OBJECTIVE: To present a surgical technique that completely releases the vascular pedicle of the nasoseptal flap from the sphenopalatine artery (SPA) foramen improving considerably the reach of the flap. METHODS: A patient with left anterior cranial base fracture involving the posterior table of the frontal sinus, who presented with cerebrospinal fluid leak and contused brain herniation to the ethmoid and frontal sinuses...
April 24, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29679781/fronto-ethmoidal-osteoma-with-secondary-intradural-mucocele-extension-causing-frontal-lobe-syndrome-and-pneumocephalus-case-report-and-review-of-the-literature
#9
Licci Maria, Zweifel Christian, Hench Jürgen, Guzman Raphael, Soleman Jehuda
BACKGROUND: Paranasal sinus osteoma is a common, asymptomatic, histologically benign, and slow-growing tumor. However, it can give rise to secondary pathologies such as a mucocele in about 50% of the cases. Rarely, intracranial and orbital extension is present leading to rhinoliquorrhea, pneumocephalus, or neurological and visual impairment, which might be potentially life-threatening. CASE DESCRIPTION: A 49-year old man presented with an acute frontal lobe syndrome and rhinoliquorrhea...
April 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29629228/cranial-autologous-bone-flap-resorption-after-a-cranioplasty-a-case-report
#10
Sabrina A de França, Thales B Nepomuceno, Wellingson S Paiva, Almir F Andrade, Manoel J Teixeira, Wagner M Tavares
Background: Craniectomies and cranioplasty are common neurosurgical procedures performed after brain trauma, ischemia, tumor resection, or infection. Post-cranioplasty autologous bone flap resorption may occur in patients after delayed cranial reconstruction. The occurrence is usually low when bone flaps are stored in subcutaneous abdominal tissue. We report a unique case of post-cranioplasty cranial bone flap. Case Description: We report a total autologous bone flap resorption in a 28-year-old man with a history of alcohol abuse...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29620651/treatment-of-giant-cavernous-aneurysm-in-an-elderly-patient-via-extracranial-intracranial-saphenous-vein-bypass-graft-in-a-hybrid-operating-room-a-case-report
#11
Can Xin, Jianjian Zhang, Zhengwei Li, Zhongwei Xiong, Bangkun Yang, Xiaolin Wu, Hao Wang, Yichun Zou, Rongqing Wu, Wenyuan Zhao, Jincao Chen
RATIONALE: Extracranial-intracranial saphenous vein bypass (EC-IC SVB) remains indispensable for treating giant cavernous aneurysms. We report an unusual case of a giant cavernous aneurysm in an elderly patient treated with EC-IC SVB in a hybrid operating room. Immediately following proximal ligation of the internal carotid artery (ICA), she suffered an acute intraoperative encephalocele. PATIENT CONCERNS: A 71-year-old woman had suffered from severe headache and double vision for 4 months...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29554345/the-role-of-the-visor-flap-in-scalp-reconstruction-a-case-series-of-21-patients
#12
Marco Ellis, Lisa Hwang, Ni-Ka Ford, Konstantin Slavin
BACKGROUND: Full-thickness scalp defects pose a reconstructive problem, especially in the setting of infection, chemotherapy/radiation, and underlying cranial defects. Current options include dermal matrices, skin grafts, and local flaps. Local flaps often fail, requiring subsequent microvascular free flap reconstruction. OBJECTIVE: To describe the visor flap, a novel bipedicled advancement flap design, and its role in reconstruction of scalp defects. METHODS: A retrospective review of 21 adult patients who developed scalp defects reconstructed using the visor flap from 2013 to 2017...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29546554/a-randomised-controlled-trial-comparing-autologous-cranioplasty-with-custom-made-titanium-cranioplasty-long-term-follow-up
#13
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...
May 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29543679/repair-of-large-full-thickness-scalp-defects-using-biomaterial-and-skin-grafting
#14
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
https://www.readbyqxmd.com/read/29543543/transcaruncular-rectus-tendon-fixation-to-the-orbit-and-frontalis-flap-for-complete-third-nerve-palsy
#15
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
https://www.readbyqxmd.com/read/29537997/autologous-breast-reconstruction-using-a-tensor-fascia-lata-anterior-lateral-thigh-freestyle-flap-after-extensive-electric-burn-a-case-report
#16
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...
May 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29526562/endoscopic-pericranial-flap-design-for-the-restoration-of-nasal-mid-vault-lining-defects
#17
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
https://www.readbyqxmd.com/read/29506334/cranially-based-nasolabial-flaps-for-the-reconstruction-of-nasal-surgical-defects
#18
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 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29504033/complication-analysis-of-complete-versus-partial-coverage-of-tissue-expanders-using-serratus-anterior-musculofascial-flaps-in-immediate-breast-reconstruction
#19
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
https://www.readbyqxmd.com/read/29470606/anatomical-and-histological-evaluation-of-the-retroauricular-fascia-flap-for-staged-auricular-reconstruction
#20
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...
June 2018: Aesthetic Plastic Surgery
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