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https://www.readbyqxmd.com/read/28212127/surgical-management-of-mandibular-intraosseous-schwannomas
#1
Anthony DeLeonibus, Bahar Bassiri Gharb, Francis Papay, James E Zins, Antonio Rampazzo
Intraosseous schwannomas of the mandible are rare tumors that usually arise from peripheral nerve sheaths of the main trunk or branches of the inferior alveolar nerve (IAN).A systematic review of the English literature through PubMed was conducted from 1945 to 2016. Forty-nine patients of mandibular intraosseous schwannomas were identified. The most common location of the tumor was the posterior mandible (61.2%). There were 28 patients in whom the tumor involved the IAN (57.1%). The most commonly performed procedures included enucleation through a mucoperiosteal flap and a bone window (73%), curettage (10%), segmental mandibulectomy (10%), and sagittal split ramus osteotomy (6%)...
February 16, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28207466/the-subunit-principle-in-scar-face-revision
#2
Ahmed Elshahat, Riham Lashin
Facial scaring is considered one of the most difficult cosmetic problems for any plastic surgeon to solve. The condition is more difficult if the direction of the scar is not parallel to relaxed skin tension lines. Attempts to manage this difficult situation included revisions using geometric designs, Z plasties or W plasties to camouflage the straight line visible scaring. The use of long-lasting resorbable sutures was tried too. Recently, the use of botulinum toxin during revision improved the results. Fractional CO2 lasers, microfat grafts, and platelet-rich plasma were added to the armamentarium...
February 15, 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
#3
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/28207197/changing-the-surgical-dogma-in-frontal-sinus-trauma-transnasal-endoscopic-repair
#4
Jessica W Grayson, Hari Jeyarajan, Elisa A Illing, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
BACKGROUND: Management of frontal sinus trauma includes coronal or direct open approaches through skin incisions to either ablate or obliterate the frontal sinus for posterior table fractures and openly reduce/internally fixate fractured anterior tables. The objective of this prospective case-series study was to evaluate outcomes of frontal sinus anterior and posterior table trauma using endoscopic techniques. METHODS: Prospective evaluation of patients undergoing surgery for frontal sinus fractures was performed...
February 16, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28205468/vascularized-medial-femoral-condyle-bone-graft-for-resistant-nonunion-of-the-distal-radius
#5
Mark Henry
BACKGROUND: Nonunion involving the metaphyseal region of the distal radius is exceedingly rare, usually involving co-morbidity. Patients that have failed multiple prior conventional surgical interventions represent an even more difficult subset to treat; this investigation examined the utility of a specially designed free vascularized medial femoral condyle flap consisting of a central structural block graft with an extended corticoperiosteal sleeve to wrap around the junctions. METHODS: Six patients (5 males, 1 female) with a mean age of 52 years had failed to achieve union involving the distal radius metaphysis after a mean of 3...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28204937/a-new-approach-to-upper-eyelid-reconstruction
#6
A Bulla, C Vielà, L Fiorot, A Bolletta, E Pancrazi, G V Campus
BACKGROUND: Reconstruction of large defects of the upper eyelid is challenging because of its complex anatomy and specialized function. The aim of this work is to develop a single-stage reconstruction procedure based on a new approach. The technique consists of the advancement of an orbicularis oculi myocutaneous flap designed within the blepharoplasty skin excision pattern. METHODS: After the tumor's excision is completed with clear margins, the borders of the flap are incised down to the submuscular plane inside the classical pattern of upper eyelid blepharoplasty...
February 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28203515/curvilinear-segmental-mandibular-reconstruction-utilizing-distraction-osteogenesis-and-early-open-callus-manipulation
#7
Alberto Rocha Pereira, Paulo Neves, José Rosa, Scott Bartlett
The authors present a new technique for reconstruction of large curvilinear mandibular defects with distraction osteogenesis and early open callus manipulation. In phase 1, transport disks are created from mandibular bone and distracted across the entire length of the defect, without the restriction from a mandible plate fixation. This allows for full-length distraction until enough regenerate is obtained to reconstruct the defect without the need for additional bone grafts. Taking advantage of the soft moldable regenerate, the second and final operative procedure allows for the manipulation, repositioning, and fixation of the transported segments in the ideal position creating perfect tridimensional form and symmetry of the mandible arch...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203511/a-retrospective-look-at-integrating-a-novel-regenerative-medicine-approach-in-plastic-limb-reconstruction
#8
Edgardo R Rodriguez Collazo, Christopher R Rathbone, Brian R Barnes
Full-thickness wounds that have rendered patients candidates for amputation may require techniques that may include a combinatorial approach above traditional standard of care. The purpose of this retrospective study was to evaluate the effectiveness of an innovative approach whereby several therapies were combined to avoid amputation. Patients with full-thickness wounds who were previously recommended for amputation and were treated with the combinatorial approach of muscle flap reconstruction and concentrated bone marrow aspirate, platelet-rich plasma, INTEGRA Wound matrix, vacuum-assisted closure, and split-thickness skin grafts were assessed retrospectively...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203501/partial-breast-reconstruction-with-goldilocks-technique-after-excision-of-giant-fibroadenoma-a-case-report
#9
Ryan P Ter Louw, Sara B Bruce, Maurice Y Nahabedian
Giant juvenile fibroadenomas are relatively rare, accounting for less than 1% fibroadenomas. Large breast tumors create significant asymmetry and provide unique reconstructive challenges after removal. In this case, we describe a 21-year-old female with delayed presentation of a giant fibroadenoma of the right breast. This represents an unusual presentation of benign breast disease requiring reduction of the skin envelope, extensive glandular resection, lower pole reconstruction, and free nipple grafting to achieve symmetry with the opposite breast...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203500/reconstructive-surgery-for-bronchopleural-fistula-and-empyema-new-application-of-free-fascial-patch-graft-combined-with-free-flap
#10
Minoru Sakuraba, Hiroki Umezawa, Shimpei Miyamoto, Masahide Fujiki, Takuya Higashino, Azusa Oshima, Masahiro Tsuboi
BACKGROUND: Postoperative bronchopleural fistula (BPF) and empyema are not uncommon after lung cancer surgery. Some patients require reconstructive surgery to achieve wound healing. In this report, we describe a novel method of reconstructive surgery for BPF and empyema. METHODS: From 1996 through 2014, we performed reconstructive surgery for the treatment of BPF and empyema in 13 cases. BPF or a pulmonary fistula was present in 11 patients at the time of reconstruction...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203499/sandwich-fascial-anterolateral-thigh-flap-in-head-and-neck-reconstruction-evolution-or-revolution
#11
Mario Cherubino, Jens Berli, Mario Turri-Zanoni, Paolo Battaglia, Francesca Maggiulli, Martina Corno, Federico Tamborini, Edoardo Montrasio, Paolo Castelnuovo, Luigi Valdatta
INTRODUCTION: The anterolateral thigh perforator flap (ALT) represents the workhorse for most reconstructive efforts in the head and neck regions. The main advantages of this flap are its versatility, the length of the pedicle, and the low morbidity of the donor site. The major drawback is the bulkiness of this flap with the frequent need for secondary revisions. To overcome this, we have developed a novel way to harvest and inset the ALT, called the sandwich fascial ALT flap (SALT). METHODS: All patients undergoing head and neck reconstruction using the SALT flap from January 2013 to March 2016 were included in this retrospective analysis...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28199294/flow-induced-microvascular-network-formation-of-therapeutic-relevant-arteriovenous-av-loop-based-constructs-in-response-to-ionizing-radiation
#12
Volker J Schmidt, Jennifer M Covi, Christoph Koepple, Johannes G Hilgert, Elias Polykandriotis, Amir K Bigdeli, Luitpold V Distel, Raymund E Horch, Ulrich Kneser
BACKGROUND The arteriovenous (AV) loop model enables axial vascularization to gain a functional microcirculatory system in tissue engineering constructs in vivo. These constructs might replace surgical flaps for the treatment of complex wounds in the future. Today, free flaps are often exposed to high-dose radiation after defect coverage, according to guideline-oriented treatment plans. Vascular response of AV loop-based constructs has not been evaluated after radiation, although it is of particular importance...
February 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28197297/reconstruction-of-an-anterior-cervical-necrotizing-fasciitis-defect-using-a-biodegradable-polyurethane-dermal-substitute
#13
Marcus Jd Wagstaff, Yugesh Caplash, John E Greenwood
Introduction: Although we have previously described the use of a novel polyurethane biodegradable dermal substitute in the reconstruction of 20 free flap donor sites, and extensive cutaneous defects, including a large area of exposed calvarium secondary to burn injury, our experience with this material now extends to 35 free flap donor site reconstructions and 13 major or complex burns. Methods: The polyurethane material (NovoSorb BTM; PolyNovo Biomaterials Pty Ltd, Port Melbourne, Victoria, Australia) was recently employed in another complex wound scenario, implanted into a large anterior cervical cutaneous and soft-tissue defect remaining after serial radical debridement for necrotizing fasciitis...
2017: Eplasty
https://www.readbyqxmd.com/read/28196713/acellular-dermal-graft-pharyngeal-repair-augmentation-after-laryngectomy
#14
Patrik Pipkorn, Parul Sinha, Joseph Zenga, Evan Graboyes, Bruce H Haughey
PURPOSE: Pharyngocutaneous fistula (PCF) after laryngectomy continues to be a serious complication, especially after radiation. Recruitment of non-radiated tissue into the surgical defect may decrease the risk of fistula. These techniques however have significant morbidity and increases operative time. We hypothesized that using acellular dermal graft to reinforce the pharyngeal closure could decrease the risk of fistula, without the added morbidity of a vascularized flap. METHODS: We performed a retrospective chart review of all patients that underwent a laryngectomy between 2005 and 2015 at an acedemic tertiary referral center...
February 2, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28196169/the-use-of-platelet-rich-fibrin-versus-subepithelial-connective-tissue-graft-in-treatment-of-multiple-gingival-recessions-a-randomized-clinical-trial
#15
Elif Öncü
The objective of this study was to evaluate the clinical effectiveness of platelet-rich fibrin (PRF) membrane used in combination with a modified coronally advanced flap (MCAF) and to compare it with the use of a subepithelial connective tissue graft (SCTG) in combination with a MCAF in treatment of Miller Class I and II bilateral multiple gingival recessions. A total of 20 patients with multiple Miller Class I and II maxillary gingival recession defects participated in this randomized, split-mouth, controlled study...
March 2017: International Journal of Periodontics & Restorative Dentistry
https://www.readbyqxmd.com/read/28196155/subperiosteal-minimally-invasive-aesthetic-ridge-augmentation-technique-smart-a-new-standard-for-bone-reconstruction-of-the-jaws
#16
Ernesto A Lee
Traditional guided bone regeneration techniques include flap mobilization and placement of a bone graft, often with the use of space-maintaining devices and cell-occlusive membranes. This approach is associated with frequent complications that negatively affect the outcome of the augmentation and the peri-implant soft tissue esthetics. Although current tunneling techniques have focused on periodontal soft tissue applications, earlier publications described their use for horizontal augmentation of mandibular posterior edentulous ridges in full-denture patients...
March 2017: International Journal of Periodontics & Restorative Dentistry
https://www.readbyqxmd.com/read/28195891/simple-skin-stretching-device-in-assisted-tension-free-wound-closure
#17
Li-Fu Cheng, Jiunn-Tat Lee, Honda Hsu, Meng-Si Wu
BACKGROUND: Numerous conventional wound reconstruction methods, such as wound undermining with direct suture, skin graft, and flap surgery, can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28195002/coverage-of-tendon-exposure-after-radial-forearm-free-flap-by-the-dorsoulnar-artery-perforator-flap
#18
Rémi Foissac, Marc Benatar, Olivier Dassonville, Alexandre Bozec, Gilles Poissonnet, Olivier Camuzard
Objective This study was designed to assess the effectiveness of an alternative technique using a perforator flap to manage secondary tendon exposure after a radial forearm free flap in head and neck oncologic surgery. Study Design Prospective cohort study. Setting Plastic Reconstructive Surgery Unit, Nice University Hospital, Pasteur 2 Hospital, France. Subjects and Methods Despite its numerous advantages, the radial forearm free flap is associated with significant donor site morbidity and the risk of secondary tendon exposure...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28185972/optimizing-sellar-reconstruction-after-pituitary-surgery-with-free-mucosal-graft-results-in-the-first-50-consecutive-patients
#19
Maria Peris-Celda, Mark Chaskes, Daniel D Lee, Tyler J Kenning, Carlos D Pinheiro-Neto
BACKGROUND: Postoperative CSF leak after endoscopic pituitary surgery ranges from 1.9-10% in different series. Vascularized flaps have reduced the incidence of leak, however it carries nasal morbidity. This paper presents a technique for sellar reconstruction with free mucosal graft from the nasal cavity floor including inferior meatus mucosa. This technique aims to standardize sellar reconstruction without the use of the nasoseptal flap and keeping the advantage of mucosal coverage of the defect in all cases...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28185018/efficacy-and-safety-of-durotomy-after-decompressive-hemicraniectomy-in-traumatic-brain-injury
#20
R B Moringlane, N Keric, F B Freimann, D Mielke, R Burger, D Duncker, V Rohde, K L V Eckardstein
Decompressive hemicraniectomy (DH) plus duroplasty was demonstrated to be effective for treating critically elevated intracranial pressure (ICP). In order to shorten operation time and to avoid the use of autologous or heterologous material, durotomy has been introduced as an alternative to duroplasty. Only limited data is available on the effect of DH and durotomy on the increased ICP in traumatic brain injury (TBI). Therefore, we collected consecutive intraoperative ICP readings during the different steps of DH and durotomy in TBI patients...
February 9, 2017: Neurosurgical Review
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