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https://www.readbyqxmd.com/read/27904754/polymethylmethacrylate-imbedded-with-antibiotics-cranioplasty-an-infection-solution-for-moderate-and-large-defects-reconstruction
#1
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
#2
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
#3
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
#4
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
#5
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...
November 15, 2016: 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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27791703/reconstruction-of-a-large-calvarial-traumatic-defect-using-a-custom-made-porous-hydroxyapatite-implant-covered-by-a-free-latissimus-dorsi-muscle-flap-in-an-11-year-old-patient
#10
Anne Morice, Frédéric Kolb, Arnaud Picard, Natacha Kadlub, Stéphanie Puget
Reconstruction of complex skull defects requires collaboration between neurosurgeons and plastic surgeons to choose the most appropriate procedure, especially in growing children. The authors describe herein the reconstruction of an extensive traumatic bone and soft tissue defect of the cranial vault in an 11-year-old boy. The size of the defect, quality of the tissues, and patient's initial condition required a 2-stage approach. Ten months after an initial emergency procedure in which lacerated bone and soft tissue were excised, reconstruction was performed...
October 28, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27777799/new-possible-surgical-approaches-for-the-submammary-adipofascial-flap-based-on-its-arterial-supply
#11
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
https://www.readbyqxmd.com/read/27622104/multiple-delayed-scalp-reconstruction-for-complicated-cranial-defects
#12
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
https://www.readbyqxmd.com/read/27609453/scalp-tissue-expansion-above-a-custom-made-hydroxyapatite-cranial-implant-to-correct-sequelar-alopecia-on-a-transposition-flap
#13
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
https://www.readbyqxmd.com/read/27595190/surgical-correction-of-lambdoid-synostosis-new-technique-and-first-results
#14
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
https://www.readbyqxmd.com/read/27591100/volume-of-brain-herniation-in-ischemic-stroke-patients-following-decompressive-craniectomy
#15
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
https://www.readbyqxmd.com/read/27567573/does-size-and-site-matter-in-therapeutic-decompressive-craniectomy-a-laboratory-based-experimental-study
#16
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
https://www.readbyqxmd.com/read/27563609/warfare-related-secondary-anterior-cranioplasty
#17
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
https://www.readbyqxmd.com/read/27556615/computed-tomographic-angiography-based-planning-of-bipedicled-diep-flaps-with-intraflap-crossover-anastomosis-an-anatomical-and-clinical-study
#18
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
https://www.readbyqxmd.com/read/27554854/evaluation-of-an-axial-pattern-flap-based-on-the-cranial-cutaneous-branch-of-the-saphenous-artery-a-cadaveric-perfusion-study
#19
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
https://www.readbyqxmd.com/read/27552303/factors-impacting-cerebrospinal-fluid-leak-rates-in-endoscopic-sellar-surgery
#20
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
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