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https://www.readbyqxmd.com/read/28230586/cranial-reconstruction-using-autologous-bone-and-methylmethacrilate
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
December 21, 2016: 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
#8
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...
January 20, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28064284/surgery-modified-pi-with-triple-bonnet-flap-and-fronto-orbital-advancement
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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