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Cranial flap

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https://www.readbyqxmd.com/read/28064284/surgery-modified-pi-with-triple-bonnet-flap-and-fronto-orbital-advancement
#1
Uday Singh Raswan, Sarbjit Singh Chhiber, Altaf Umar Ramzan
INTRODUCTION: Craniosynostosis is the premature fusion of one or more of the cranial sutures and can occur as part of a syndrome or as an isolated defect. Pansynostosis is a rare form of craniosynostosis that involves premature fusion of all the cranial sutures (coronal, sagittal, metopic, and occipital). Particularly in cases of late presentation, there are heightened clinical concerns, both functional and aesthetic. In untreated cases of pansynostosis and increased intracranial pressure, optic nerve damage progresses to optic atrophy and then blindness...
January 7, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28045814/recalcitrant-invasive-skin-cancer-of-the-scalp-combined-extirpation-and-microsurgical-reconstruction-without-cranioplasty
#2
Gerald J Cho, Frederick Wang, Steven M Garcia, Jennifer Viner, William Y Hoffman, Michael W McDermott, Jason H Pomerantz
BACKGROUND: Recurrent invasive skin cancer of the scalp and calvarium is a difficult problem for which universally accepted treatment protocols have not been established. The authors present their 10-year experience with treatment of this specific subset of scalp reconstruction patients and present a successful treatment algorithm that is well suited to this patient population. METHODS: The authors retrospectively reviewed all patients of microsurgical scalp reconstruction performed from 2005 to 2015 that involved invasive cutaneous malignancies of the scalp and calvarium...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28027200/vascular-supply-of-the-auricle-anatomical-study-and-applications-to-external-ear-reconstruction
#3
Michaël Hénoux, Florent Espitalier, Antoine Hamel, Brigitte Dréno, Guillaume Michel, Olivier Malard
BACKGROUND: Reliable reconstructive flaps require convenient vascular supply. Thus, precise description of the vascular patterns of external ear is not completely elucidated. OBJECTIVE: This anatomical study aims to provide comprehensive data of the arterial network of the auricular region, anastomosis, and patterns of arterial dependence regarding external ear subunits. MATERIALS AND METHODS: After dyed latex injections in the external carotid artery, eleven auricles have been carefully dissected to examine the vascular network of the auricular region...
January 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/27993742/immediate-titanium-mesh-implantation-for-patients-with-postcraniotomy-neurosurgical-site-infections-a-safe-and-esthetic-alternative-procedure
#4
Gregory Ehrlich, Stefanie Kindling, Holger Wenz, Daniel Hänggi, Dirk Michael Schulte, Peter Schmiedek, Marcel Seiz-Rosenhagen
BACKGROUND: Surgical site infection (SSI) is one of the main complications after craniotomy. The incidence is up to 11% in the literature. The established procedure is debridement, removal of the bone flap and delayed cranioplasty. Delayed cranioplasty has several disadvantages. A promising approach is the immediate titanium mesh implantation at the time of wound revision. We want to report our experience with this technique with regard to outcome measured by reinfection rates and patient satisfaction...
December 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27993740/a-technically-simple-and-safe-method-for-preparing-an-anterior-pericranial-flap-using-saline-injection-into-the-subgaleal-space-a-technical-note
#5
Jiwook Ryu, Sang Bong Chung, Seok Keun Choi, Sung Ho Lee, Yeongu Chung
INTRODUCTION: Cranial defects following anterior cranial base surgery have been frequently reconstructed using the pericranial flap. We present a simple technique for preparing the flap using injection of saline into the subgaleal space. SURGICAL TECHNIQUE: Ten minutes before skin incision, we inserted a 20-gauge needle perpendicular to 8-10 spots in the frontal area and injected 5-7 cc of saline at each spot. Distinctive swelling of the scalp was then observed...
December 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27986527/effects-of-orbicularis-oculi-flap-anchorage-to-the-periosteum-of-the-upper-orbital-rim-on-the-lower-eyelid-position-after-transcutaneous-blepharoplasty-statistical-analysis-of-clinical-outcomes
#6
Alessandro Innocenti, Francesco Mori, Dario Melita, Emanuela Dreassi, Marco Innocenti
BACKGROUND: The aging process affects the skin, muscle, and fat of the eyes in a different manner. Their individual rejuvenation would require specific surgical treatments according to their particular demands. In the present study, we analyzed the effect of an orbicularis oculi muscle flap fixed to the superior orbital rim to prevent lower eyelid dislocation during transcutaneous blepharoplasty. METHODS: The study was conducted retrospectively comparing pre- and postoperative images of two different groups of patients: group A (20 patients) treated with an orbicularis oculi flap and group B (17 patients) treated without the flap...
November 11, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27975017/endoscopic-adipofascial-radial-forearm-flap-reconstruction-of-a-clival-defect
#7
Trevor G Hackman
Skull base surgical defects present unique challenges to anatomic and functional reconstruction. Fortunately, many endonasal skull base defects are successfully managed with a variety of local and regional reconstructive techniques. However, when prior surgery or radiotherapy eliminates the use of these local and regional reconstructive options, more elaborate free tissue transfer techniques are required. Managing endoscopic skull base defects of the anterior cranial fossa and clivus is further complicated by the limited access afforded for flap inset...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27935362/dramatic-radiographic-response-resulting-in-cerebrospinal-fluid-rhinorrhea-associated-with-sunitinib-therapy-in-recurrent-atypical-meningioma-case-report
#8
Amol Raheja, Howard Colman, Cheryl A Palmer, William T Couldwell
Sunitinib is a multiple tyrosine kinase inhibitor with antiangiogenic, cytostatic, and antimigratory activity for meningiomas. A recent clinical trial of sunitinib for treatment of recurrent Grade II and III meningiomas suggested potential efficacy in this population, but only 2 patients exhibited significant radiographic response with tumor volume reduction. The authors illustrate another such case and discuss a complication related to this dramatic tumor volume reduction in aggressive skull base meningiomas...
December 9, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27931166/complications-of-skull-reconstruction-after-decompressive-craniectomy
#9
Michiel Herteleer, Nadine Ectors, Joost Duflou, Frank Van Calenbergh
INTRODUCTION: Decompressive craniectomy can be a life-saving procedure. Later reconstruction of the skull using the stored bone flap ("cranioplasty") is often associated with complications. These complications require new procedures and often result in the reconstruction of the skull using an expensive patient-specific cranial implant. PATIENTS & METHODS: All adult patients who underwent cranioplasty after decompressive craniectomy in the last 10 years in our center were included (74 patients)...
December 8, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27929602/facial-reanimation-according-to-the-postresection-defect-during-lateral-skull-base-surgery
#10
John P Leonetti, Sahar Nadimi, Sam J Marzo, Douglas Anderson, Darl Vandevender
The vast majority of benign tumors of the cerebellopontine angle, temporal bone, and parotid gland can be successfully resected without permanent injury to the facial nerve. Malignant tumors or recurrent disease may require facial nerve sacrifice, especially if preoperative facial paresis is present. This article will present case examples of the various methods to reconstruct facial animation after lateral skull base resections that require sacrifice of cranial nerve VII, and the associated mimetic facial musculature...
December 2016: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/27923230/skull-subsidence-due-to-periosteum-defect-following-craniotomy-in-a-child
#11
Hidetaka Arishima, Ayumi Akazawa, Ken-Ichiro Kikuta
We report a case of a 7-year-old child with a cranial deformity secondary to a craniotomy for an intracranial hematoma. He suffered from an acute epidural hematoma with a lineal fracture of the right temporal bone following a severe head injury. A large question mark-shaped skin flap with the periosteum and temporal muscle was created for a decompressive craniectomy; however, neither the acute epidural hematoma nor brain swelling was severe, and we performed a small craniotomy compared with the skin flap without a decompressive craniectomy...
December 7, 2016: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27904754/polymethylmethacrylate-imbedded-with-antibiotics-cranioplasty-an-infection-solution-for-moderate-and-large-defects-reconstruction
#12
Paulo Valdeci Worm, Tobias Ludwig do Nascimento, Fabricio do Couto Nicola, Eduardo Farias Sanches, Carlos Fernando Dos Santos Moreira, Luiz Pedro Willimann Rogério, Marcelo Martins Dos Reis, Guilherme Finger, Marcus Vinicius Martins Collares
BACKGROUND: In cases where autologous bone graft reconstruction is not possible (such as comminuted fractures, bone graft reabsorption, or infection) and the use of synthetic material is required, polymethylmethacrylate (PMMA) use is a safe and efficient solution. Studies comparing the incidence of postoperative complications between autologous and synthetic cranioplasty are heterogeneous, not allowing a conclusion of which is the best material for skull defects reconstruction. Current medical literature lacks prospective well-delineated studies with long-term follow-up that analyze the impact of antibiotic use in PMMA cranial reconstruction of moderate and large defects...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27904429/there-are-no-differences-between-factors-determining-graft-infection-in-autologous-bone-flap-replacement-and-acrylic-cranioplasty-a-prospective-observational-study-at-hospital-kuala-lumpur
#13
Siti Azleen Mohamad, Mohd Safari Mohd Haspani, Badrisyah Idris
OBJECTIVES: This study, conducted in 2012, was performed to determine the incidence of graft infection after cranioplasty procedures and factors affecting the graft infection rate at Hospital Kuala Lumpur (HKL). METHODOLOGY: This was an observational cross-sectional case study of patients who have undergone cranioplasty at HKL over a period of one year (2012). One hundred seventy-two patients were included in the study. A total of 105 (61.8%) cases were autologous bone flap replacements, and 67 (38...
September 2016: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/27903119/the-learning-curve-in-endoscopic-endonasal-resection-of-craniopharyngiomas
#14
Varun R Kshettry, Hyunwoo Do, Khaled Elshazly, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
OBJECTIVE There is a paucity of literature regarding the learning curve associated with performing endoscopic endonasal cranial base surgery. The purpose of this study was to determine to what extent a learning curve might exist for endoscopic endonasal resection in cases of craniopharyngiomas. METHODS A retrospective review was performed for all endoscopic endonasal craniopharyngioma resections performed at Thomas Jefferson University from 2005 to 2015. To assess for a learning curve effect, patients were divided into an early cohort (2005-2009, n = 20) and a late cohort (2010-2015, n = 23)...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27903020/dynamic-decompressive-craniotomy-with-a-novel-reversibly-expandable-plate
#15
Rohit Khanna
Objective To assess the feasibility of a dynamic craniotomy procedure with the use of a novel reversibly expandable cranial bone flap fixation plate. The expandable plate allows outward bone flap migration with an increase in intracranial volume or intracranial pressure (ICP). Methods Dynamic craniotomy intracranial hypertension compliance was evaluated in a skull model with progressive increase in intracranial volume and compared with the standard craniotomy with fixed plates. Results Dynamic craniotomy provided significant control of ICP with increasing intracranial volume compared with the standard craniotomy...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27894916/reliability-of-extended-dorsal-intercostal-artery-perforator-propeller-flaps-for-reconstruction-of-large-myelomeningocele-defects
#16
Goktekin Tenekeci, Yavuz Basterzi
Reconstruction of large myelomeningocele defects using extended (elongated beyond the lateral margin of the latissimus dorsi muscle) dorsal intercostal artery perforator (DICAP) propeller flaps is not recommended by previous studies. However, to provide tension-free and successful closure of a defect, the DICAP propeller flaps must sometimes be elongated beyond this margin. Our experience and results in this issue are discussed. In this article, reconstruction of 11 consecutive cases, with large myelomeningocele defects in which standard DICAP propeller flaps were incapable to close the defect, was achieved using extended DICAP propeller flaps between June 2013 and November 2015...
January 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27894610/-reconstruction-of-proximal-nasal-defect-after-deep-carcinological-resection-interest-to-combine-titane-mesh-with-fat-grafting
#17
R Aimard, C Lalloué, C Ho Quoc, D Girodet, P Zrounba, E Delay
INTRODUCTION: The mucosal cylindroma or adenoid cystic carcinoma is the second sinonasal non-epithelial malignant tumor frequency argument. Due to the achievement of the nasal mucosa and a late diagnosis reconstructions are often complex. We report the case of a mucous cylindroma recurrence of nasal septum requiring a wide and deep excision of the root of the nose with nasal reconstruction. CASE REPORT: A patient aged 66 years whose history resection two years ago with a mucous adenoid cystic carcinoma of the right side of the nasal septum, had a local recurrence T2NOM0 imposing a wide excision with amputation nasal septum own bones of nose, the anterior portion of the triangular cartilages...
November 25, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/27888912/extended-endoscopic-and-open-sinus-surgery-for-refractory-chronic-rhinosinusitis
#18
REVIEW
Jean Anderson Eloy, Emily Marchiano, Alejandro Vázquez
This review discusses extended endoscopic and open sinus surgery for refractory chronic rhinosinusitis. Extended maxillary sinus surgery including endoscopic maxillary mega-antrostomy, endoscopic modified medial maxillectomy, and inferior meatal antrostomy are described. Total/complete ethmoidectomy with mucosal stripping (nasalization) is discussed. Extended endoscopic sphenoid sinus procedures as well as their indications and potential risks are reviewed. Extended endoscopic frontal sinus procedures, such the modified Lothrop procedure, are described...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27845963/internal-distraction-osteogenesis-with-piezosurgery-oblique-osteotomy-of-supraorbital-margin-of-frontal-bone-for-the-treatment-of-unilateral-coronal-synostosis
#19
Weimin Shen, Jie Cui, Jianbing Chen, Yi Ji, Liangliang Kong
PURPOSE: To assess the utility of internal distraction osteogenesis with Piezosurgery oblique osteotomy of supraorbital margin of frontal bone for the treatment of unilateral coronal synostosis and to study the outcome and complications of this procedure. Oblique osteotomy allows for entry into the cranial cavity, and along with parallel cut to the roof of the orbit, avoids the need to cut into the orbit which forms the frontal flap. METHODS: Oblique osteotomy was performed along the supraorbital rim to do a frontal suture of the glabella (ages of patients were less than 1 year) or on the opposite side of the supraorbital rim (ages of patients were older than 1 year) after performing a suturectomy of the effected coronal suture...
November 15, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27833717/two-stage-cranioplasty-tissue-expansion-directly-over-the-craniectomy-defect-prior-to-cranioplasty
#20
Ellianne Jacira Dos Santos Rubio, Eelke M Bos, Ruben Dammers, Maarten J Koudstaal, Anton G Dumans
Performing a skull reconstruction for a long-term existing large cranium defect usually needs either skin enhancement or skin flaps and cranioplasty. This procedure can be accompanied with aesthetic and functional complications. The presented case describes a 27-year-old man in need of a cranial reconstruction following decompressive craniectomy as treatment for severe traumatic brain injury. Autologous cranioplasty after decompressive craniectomy failed due to bone flap infection. Because of cognitive behavioral problems, a protective helmet needed to be worn in awaiting cranioplasty...
November 2016: Craniomaxillofacial Trauma & Reconstruction
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