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https://www.readbyqxmd.com/read/28434964/reconstruction-of-cranial-vault-defect-with-polyetheretherketone-peek-implants
#1
Pierre Brandicourt, Franck Delanoé, Franck-Emmanuel Roux, Florian Jalbert, David Brauge, Frédéric Lauwers
OBJECT: Reconstruction of a cranial vault defect is a frequent challenge in neurosurgery. Polyetheretherketone (PEEK) is used in many types of prostheses and has been employed for 10 years in our institution (University Hospital of Toulouse - France). The objectives of this study are to describe the benefits and drawbacks of reconstructing the cranial vault defect with a PEEK prosthesis. METHODS: Clinical data of the 37 patients who received a reconstruction with a custom-made PEEK prosthesis from 2007 to 2015 were retrospectively analysed...
April 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28431953/cryostored-autologous-skull-bone-for-cranioplasty-a-study-on-cranial-bone-flaps-viability-and-microbial-contamination-after-deep-frozen-storage-at-80%C3%A2-c
#2
David Yuen Chung Chan, Yi Tan Mok, Ping Kuen Lam, Cindy See Wai Tong, Stephanie Chi Ping Ng, Tin Fung David Sun, Wai Sang Poon
Craniectomy is a life-saving procedure. Subsequent cranioplasty with autologous skull bone has a bone resorption rate from 4% to 22.8% and an infection rate from 3.3% to 26%. There are concerns with their viability and the potential microbial contamination as they were explanted for a long period of time. Eighteen cranial bone flaps stored at Prince of Wales Hospital Skull Bone Bank during the period from June 2011 to March 2016 were identified. Ethics approval was obtained. Bone chips and deep bone swabs were collected for osteoblast culture and microbial culture...
April 18, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28364148/robotic-valvuloplastic-esophagogastrostomy-using-double-flap-technique-following-proximal-gastrectomy-technical-aspects-and-short-term-outcomes
#3
Susumu Shibasaki, Koichi Suda, Masaya Nakauchi, Kenji Kikuchi, Shinichi Kadoya, Yoshinori Ishida, Kazuki Inaba, Ichiro Uyama
BACKGROUND: Valvuloplastic esophagogastrostomy by double flap technique (VEG-DFT) is a promising procedure to prevent reflux after proximal gastrectomy (PG), and is achieved by the burial of the abdominal esophagus into the gastric submucosa; however, laparoscopic VEG-DFT is technically demanding due to complicated suturing and ligation maneuvers. The present study was designed to determine the feasibility and safety of robotic VEG-DFT. METHODS: After robotic PG, seromuscular flaps were extracorporeally created at the anterior wall of the remnant stomach through a small umbilical incision...
March 31, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28321385/the-laparoscopically-harvested-omental-free-flap-a-compelling-option-for-craniofacial-and-cranial-base-reconstruction
#4
Peter D Costantino, David Shamouelian, Tristan Tham, Robert Andrews, Wojciech Dec
Background Management of craniofacial and cranial base tumors is a challenge due to the anatomic intricacies associated with the calvarium, the pathological diversity of lesions that present, and the potential complications. Clinical outcomes in laparoscopically harvested omentum free flaps for cranial base and craniofacial reconstruction are presented in this paper, in the largest case series to date. Methods A retrospective single-center experience for over 10 years with laparoscopically harvested omentum flaps used to reconstruct craniofacial and cranial base defects...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28293502/microvascular-fragment-transplantation-improves-rat-dorsal-skin-flap-survival
#5
Randolph Stone, Christopher R Rathbone
BACKGROUND: The development of flap necrosis distally remains a concern during microsurgical flap transfers because, at least in part, of decreased perfusion. Microvascular fragments (MVFs) are microvessels isolated from adipose tissue that are capable of improving tissue perfusion in a variety of tissue defects. The aim of this study was to determine whether the transplantation of MVFs in a dorsal rat skin flap model can improve flap survival. METHODS: A 10 × 3 cm flap was raised in a cranial to caudal fashion on the dorsal side of 16 Lewis rats, with the caudal side remaining intact...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28230586/cranial-reconstruction-using-autologous-bone-and-methylmethacrilate
#6
Nenad Novaković, Ana Malivuković, Ljubodrag Minić, Milan Lepić, Stefan Mandić-Rajčević, Lukas Rasulić
BACKGROUND: Having in mind the importance of reconstruction of the calvaria, our goal was to compare the complication rates following the use of autologous bone and methylmethacrilate grafts, and explain the factors influencing them. METHODS: The authors collected information of all the patients undergoing cranial reconstructive surgery (N = 149) at the Military Medical Academy in Belgrade. Procedures were performed either using a craniotomy bone flap, removed and replaced in the same act, or using methylmethacrilate...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28207463/implantation-of-thickened-artificial-bone-for-reduction-of-dead-space-and-prevention-of-infection-between-implant-and-dura-in-secondary-reconstruction-of-the-skull
#7
Mine Ozaki, Keigo Narita, Masakazu Kurita, Yuki Iwashina, Akihiko Takushima, Kiyonori Harii
For the treatment of skull defect compensation after neurosurgery, a customized artificial bone is often employed owing to its toughness and the relative ease of producing cosmetically good result. However, implants are vulnerable to infection and removal of implant is sometimes necessary. Several other treatment options such as autologous bone graft or free flap are likely to be considered for the secondary reconstruction to avoid reinfection; however, reimplantation of artificial bone is beneficial for the patients, being not concerned with donor site morbidity...
February 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28187214/what-s-the-remedy-for-the-distal-necrosis-of-diep-flap-better-venous-drain-or-more-arterial-supply
#8
Yi Zhang, Tingliang Wang, Jiao Wei, Jinguang He, Tao Wang, Ying Liu, Hua Xu, Jiasheng Dong
BACKGROUND: We developed a novel pedicled DIEP flap model in rat to explore the possible remedy for the distal necrosis of the flap. METHODS: A deep inferior epigastric perforator (DIEP) flap, based on the second right cranial perforator (P2) as the main pedicle, was elevated in 48 Sprague-Dawley rats. The rats were randomized into 4 groups: group I, the left P2 remaining intact as supercharging; group II, the left P2 artery alone kept as supercharging; group III, the left P2 vein alone kept as supercharging; group IV, no supercharging...
2017: PloS One
https://www.readbyqxmd.com/read/28137547/repeat-intracranial-expansion-after-skull-re-growth-in-hyperostotic-disease-a-technical-note
#9
Timothy Wong, Yehuda Herschman, Nitesh V Patel, Tushar Patel, Simon Hanft
OBJECTIVE: and Importance: Camurati-Engelmann's disease (CED) is a rare, autosomal dominant genetic disorder resulting in hyperostosis of the long bones and skull.(1-4) Patients often develop cranial nerve dysfunction and increased intracranial pressure secondary to stenosis of nerve foramina and hyperostosis.(1-11) Surgical decompression may provide symptomatic relief in select patients; however, a small number of reports document the recurrence of symptoms due to bony regrowth.(1, 6, 7, 9-11) We present a patient who had previously been treated with bilateral frontal and parietal craniotomy that experienced recurrence of symptoms due to re-ossification of her cranial bones...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28120070/tips-and-tricks-for-anterior-cranial-base-reconstruction
#10
Oreste de Divitiis, Alberto Di Somma, Luigi Maria Cavallo, Paolo Cappabianca
Reconstruction procedures come last in skull base surgery, but they are not the least important phase-rather, reconstruction is one of the most important steps required to prevent complications. In our opinion, there are three general principles upon which a good reconstruction of the skull base stand: (1) anatomo-surgical knowledge; (2) approach/route selection; and (3) the cooperation of the skull base surgical team. In general, three major complications may occur when a good skull base reconstruction has not been achieved, i...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28118198/microvascular-tissue-transfers-for-midfacial-and-anterior-cranial-base-reconstruction
#11
Ali Emre Aksu, Hakan Uzun, Ozan Bitik, Gökhan Tunçbilek, Tunç Şafak
Reconstruction of a midfacial defect can represent a difficult challenge for the plastic surgeon. Although many midfacial deformities have traumatic or congenital origins, the vast majority of head and neck defects occur after resection of malignant head and neck neoplasms. Autogenous reconstruction is now routinely performed for larger, complex defects resulting from surgical resection or trauma. In this study, the authors present 27 patients with midfacial defects reconstructed with free flaps. Twenty-two of the defects were created by surgical ablation of cancer (maxillectomy) and the others were traumatic...
January 23, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28108241/levator-alae-nasi-muscle-v-y-island-flap-for-nasal-tip-reconstruction
#12
Simone La Padula, Vincenzo Abbate, Gianluca Di Monta, Fabrizio Schonauer
Nasal tip reconstruction can be very challenging. It requires close attention to skin texture, colour and thickness matching, with the respect of the nasal aesthetic units and symmetry. Flaps are usually preferred to skin grafts where possible. Based on different donor areas, various flaps have been described for reconstruction of this region. Here we present a new V-Y myocutaneous island flap based on the levator alae nasi muscle (LAN muscle) blood supply. This flap may represent an alternative to the nasalis myocutaneous sliding V-Y flap previously described by Rybka...
March 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28106514/endonasal-management-of-pediatric-congenital-transsphenoidal-encephaloceles-nuances-of-a-modified-reconstruction-technique-technical-note-and-report-of-3-cases
#13
Mehdi Zeinalizadeh, Seyed Mousa Sadrehosseini, Zohreh Habibi, Farideh Nejat, Harley Brito da Silva, Harminder Singh
OBJECTIVE Congenital transsphenoidal encephaloceles are rare malformations, and their surgical treatment remains challenging. This paper reports 3 cases of transsphenoidal encephalocele in 8- to 24-month-old infants, who presented mainly with airway obstruction, respiratory distress, and failure to thrive. METHODS The authors discuss the surgical management of these lesions via a minimally invasive endoscopic endonasal approach, as compared with the traditional transcranial and transpalatal approaches. A unique endonasal management algorithm for these lesions is outlined...
March 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28064284/surgery-modified-pi-with-triple-bonnet-flap-and-fronto-orbital-advancement
#14
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...
2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28045814/recalcitrant-invasive-skin-cancer-of-the-scalp-combined-extirpation-and-microsurgical-reconstruction-without-cranioplasty
#15
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...
March 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28027200/vascular-supply-of-the-auricle-anatomical-study-and-applications-to-external-ear-reconstruction
#16
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-safe-and-aesthetic-alternative-procedure
#17
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 report our experience with this technique regarding outcome measured by reinfection rates and patient satisfaction...
March 2017: 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
#18
Jiwook Ryu, Sang Bong Chung, Seok Keun Choi, Sung Ho Lee, Yeongu Chung
BACKGROUND: Cranial defects following anterior cranial base surgery have been frequently reconstructed using the pericranial flap. METHODS: We present a simple technique for preparing the flap using injection of saline into the subgaleal space. RESULTS: We inserted a 20-gauge needle perpendicular to 8-10 spots in the frontal area and injected 5-7 mL of saline at each spot 10 minutes before skin incision. Distinctive swelling of the scalp was then observed...
March 2017: 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
#19
COMPARATIVE STUDY
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...
March 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27975017/endoscopic-adipofascial-radial-forearm-flap-reconstruction-of-a-clival-defect
#20
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
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