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https://www.readbyqxmd.com/read/28109490/risk-factors-for-cerebrospinal-fluid-leak-in-pediatric-patients-undergoing-endoscopic-endonasal-skull-base-surgery
#1
Amanda L Stapleton, Elizabeth C Tyler-Kabara, Paul A Gardner, Carl H Snyderman, Eric W Wang
OBJECTIVES: To determine the risk factors associated with cerebrospinal fluid (CSF) leak following endoscopic endonasal surgery (EES) for pediatric skull base lesions. METHODS: Retrospective chart review of pediatric patients (ages 1 month to 18 years) treated for skull base lesions with EES from 1999 to 2014. Five pathologies were reviewed: craniopharyngioma, clival chordoma, pituitary adenoma, pituitary carcinoma, and Rathke's cleft cyst. Fisher's exact tests were used to evaluate the different factors to determine which had a statistically higher risk of leading to a post-operative CSF leak...
February 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28109470/the-fate-of-the-free-flap-pedicle-after-free-tissue-transfer-to-the-head-and-neck-area
#2
Maarten L V Van Genechten, Martin D Batstone
OBJECTIVES: Little is understood about what happens to the vascular pedicle following free tissue transfer in the head and neck region. The viability of a free flap completely depends on the vascular supply by its vascular pedicle until neovascularization occurs from surrounding tissues. The aim of this study is to find out how long a vascular pedicle lasts following free tissue transfer in the head and neck region. MATERIALS AND METHODS: Patients were recruited from the Maxillofacial Unit at the Royal Brisbane & Women's Hospital...
February 2017: Oral Oncology
https://www.readbyqxmd.com/read/28109397/video-assisted-intercostal-muscle-flaps-for-bronchial-stump-coverage
#3
Derek R Serna-Gallegos, Robert J McKenna
This article describes the surgical technique for performing an intercostal muscle flap for bronchial stump coverage using a video-assisted thoracic surgery approach.
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28108115/a-reappraisal-of-the-surgical-planning-of-the-superficial-circumflex-iliac-artery-perforator-flap
#4
Shaoqing Feng, Wenjing Xi, Zheng Zhang, Mathias Tremp, Dirk J Schaefer, Parviz L Sadigh, Wenjie Zhang, Yi Xin Zhang
OBJECTIVE: The popularity of the superficial circumflex iliac artery perforator (SCIP) flap has been limited by factors such as variable vascular anatomy and short arterial pedicle. This article aimed to delineate flap design and harvest strategies based around either the proximal or distal perforators of the superficial circumflex iliac artery (SCIA) and propose a set of strategies that can help deal with the limitations of the flap. METHOD: From August 2011 to June 2015, the SCIP flap was used in 80 patients for soft tissue defects at our institution...
December 22, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28107239/management-of-pharyngeal-fistulas-after-anterior-cervical-spine-surgery-a-treatment-algorithm-for-severe-complications
#5
Christian Simon, Carl H Fürstenberg, Markus Eichler, Stefan Rohde, Cem Bulut, Bernd Wiedenhöfer
STUDY DESIGN: This study is a retrospective database query to identify all anterior spinal approaches. OBJECTIVES: The objectives were to assess all patients with pharyngocutaneous fistulas (PCFs) after anterior cervical spine surgery. SUMMARY OF BACKGROUND DATA: Patients with the diagnosis of PCFs were treated at the University of Heidelberg Spine Medical Center, Spinal Cord Injury Unit and Department of Otolaryngology (Germany), between 2005 and 2011...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28106703/clinical-application-of-a-pedicled-forearm-flap-in-the-reconstruction-after-oral-cancer-resection
#6
Xiaoqiang Zhao, Youmei Zhang, Shuai Fu, Changbin Zhang, Ming Li, Yong Wu
OBJECTIVE: To investigate the clinical application of a pedicled forearm flap in the reconstruction of soft tissue defects after oral cancer resection. METHODS: A retrospective analysis was performed on 31 patients with oral cancer in the Affiliated Stomatology Hospital of Kunming Medical University. The patients underwent repair of soft tissue defects, resulting from oral cancer resection, using a pedicled forearm flap. Patients were followed up for 3 months to 3 years to observe the survival rate of the pedicled forearm flap and the recovery of the patient's appearance and oral function...
January 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28106695/velopharyngeal-insufficiency-after-le-fort-i-osteotomy-in-a-patient-with-undiagnosed-occult-submucous-cleft-palate
#7
Rushil R Dang, Bonnie L Padwa, Cory M Resnick
The authors present a 16-year-old patient with no known history of cleft palate who developed velopharyngeal insufficiency after a Le Fort I osteotomy performed for the correction of maxillary hypoplasia and a Class III malocclusion. Postoperative evaluation revealed the presence of velopharyngeal insufficiency and subtle findings of an occult submucous cleft palate. She had a pharyngeal flap 6 months later with successful correction of the velopharyngeal insufficiency. This case illustrates the need to screen for submucous cleft palate prior to orthognathic surgery...
January 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28106627/outcomes-after-elevation-of-serratus-anterior-fascia-during-prosthetic-breast-reconstruction
#8
Akhil K Seth, Elliot M Hirsch, John Y S Kim, Neil A Fine
BACKGROUND: Achieving optimal inferolateral coverage is critical to successful prosthetic breast reconstruction. Serratus anterior fascia (SF) elevation, a promising alternative to muscle flaps and acellular dermis (ADM), has not been rigorously studied. This study evaluates complication rates after mastectomy and immediate tissue expander (TE) coverage using SF, relative to other existing methods of reconstruction. METHODS: Retrospective review of consecutive patients undergoing mastectomy with immediate TE reconstruction over 10 years at 1 institution was performed...
January 19, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28101947/combined-surgical-therapy-of-advanced-peri-implantitis-evaluating-two-methods-of-surface-decontamination-a-7-year-follow-up-observation
#9
Frank Schwarz, Gordon John, Andrea Schmucker, Narja Sahm, Jürgen Becker
OBJECTIVES: To assess the long-term outcomes (>4 years) following combined surgical resective/regenerative therapy of advanced peri-implantitis lesions using two surface decontamination methods. MATERIAL & METHODS: Fifteen patients (n = 15 combined supra- and intrabony defects) completed a follow-up observation period of 7 years. The treatment procedure included access flap surgery, granulation tissue removal and implantoplasty at buccally and supracrestally exposed implant parts, and a randomly assigned decontamination of the unmodified intrabony implant surface areas using either (i) an Er:YAG laser (ERL) or (ii) plastic curettes + cotton pellets + sterile saline (CPS)...
November 7, 2016: Journal of Clinical Periodontology
https://www.readbyqxmd.com/read/28101431/non-invasive-terahertz-imaging-of-tissue-water-content-for-flap-viability-assessment
#10
Neha Bajwa, Joshua Au, Reza Jarrahy, Shijun Sung, Michael C Fishbein, David Riopelle, Daniel B Ennis, Tara Aghaloo, Maie A St John, Warren S Grundfest, Zachary D Taylor
Accurate and early prediction of tissue viability is the most significant determinant of tissue flap survival in reconstructive surgery. Perturbation in tissue water content (TWC) is a generic component of the tissue response to such surgeries, and, therefore, may be an important diagnostic target for assessing the extent of flap viability in vivo. We have previously shown that reflective terahertz (THz) imaging, a non-ionizing technique, can generate spatially resolved maps of TWC in superficial soft tissues, such as cornea and wounds, on the order of minutes...
January 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28099975/functional-outcome-of-cad-cam-assisted-versus-conventional-microvascular-fibular-free-flap-reconstruction-of-the-mandible-a-retrospective-study-of-30-cases
#11
Lucas M Ritschl, Thomas Mücke, Andreas Fichter, Florian D Güll, Christopher Schmid, Jean Marc Pho Duc, Marco R Kesting, Klaus-Dietrich Wolff, Denys J Loeffelbein
Background Different advantages of virtually planned and guided mandibular reconstructions have been described. Functional analyses and comparisons with conventionally reconstructed patients. Methods We retrospectively analyzed 30 cases of mandibular reconstructions that involved virtually planned or conventional microvascular, fibular free flaps that occurred between April 2011 and December 2014 at a single center. The results were also compared with a healthy cohort of 30 participants. Axiographic measurements were performed postoperatively, and uni- and multivariate regressions analyses were performed to determine the association between possible predictor variables on functional outcome...
January 18, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28099360/aggressive-intramuscular-hemangiomas-in-the-upper-extremity-a-case-report
#12
Hui Lu, Qiang Chen, Hu Yang, Hui Shen
INTRODUCTION: Intramuscular hemangioma (IMH) is a rare congenital soft tissue tumor. Here, we report a case of IMH patient who had undergone several surgeries and other treatments that were all ineffective before he visited us. CLINICAL FINDINGS: This IMH patient was a 16-yearold male who was born with a tumor of unknown size in his right hand and forearm. On physical examination, the tumor and skin flap complex was seen with a size of 14 cm_12 cm in his right hand, and the multiple postoperative scars were shown on his right hand and forearm...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28099173/surgical-approach-for-ulcerated-locally-advanced-breast-cancer-a-single-center-experience-a-retrospective-study
#13
Rita Laforgia, Clelia Punzo, Annunziata Panebianco, Annalisa Volpi, Marina Minafra, Maria Grazia Sederino
AIM: The aim of our retrospective study is to analyze surgical possibilities for the extended LABC in those cases not suitable for a neoadjuvant chemotherapy step and to consider various reconstruction techniques. MATERIAL OF STUDY: Between 2009 and 2015 we enrolled 11 patients, admitted to the Emergency Department, presenting ulcerated LABC that needed palliative surgical demolitive procedures because of bleeding and anemia and in which was necessary to use natural tissues transposition or synthetic substitutes for the reconstruction of the skin flaps...
January 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28096323/pyoderma-gangrenosum-following-complex-reconstruction-of-a-large-scale-lower-limb-defect-by-combined-parascapular-and-latissimus-dorsi-flap
#14
Tomke Cordts, Amir K Bigdeli, Leila Harhaus, Christoph Hirche, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
A female patient with a critical soft tissue defect after elective knee replacement surgery was transferred to our department for reconstruction. As wounds were rapidly progressing, necrotizing fasciitis was initially suspected but eventually ruled out by histopathological analysis. A 50 × 15 cm defect was then reconstructed by means of a combined Parascapular and latissimus dorsi flap before, a couple days later, the patient developed tender pustules and ulcers involving the flap as well as the donor site...
January 17, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28095995/pelvic-floor-reconstruction-by-modified-rectus-abdominis-myoperitoneal-mram-flap-after-pelvic-exenterations
#15
D Cibula, M Zikan, D Fischerova, R Kocian, A Germanova, A Burgetova, L Dusek, Z Fartáková, M Schneiderová, K Nemejcová, J Slama
OBJECTIVE: To describe the technique and report experiences with pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after extensive pelvic procedures. METHODS: Surgical technique of MRAM harvest and transposition is carefully described. The patients in whom pelvic floor reconstruction with MRAM after either infralevator pelvic exenteration and/or extended lateral pelvic sidewall excision was carried out were enrolled into the study (MRAM group, n=16)...
January 14, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28095867/effects-of-ablation-depth-and-repair-time-on-the-corneal-elastic-modulus-after-laser-in-situ-keratomileusis
#16
Xiaojun Wang, Xiaona Li, Weiyi Chen, Rui He, Zhipeng Gao, Pengfei Feng
BACKGROUND: The biomechanical properties of the cornea should be taken into account in the refractive procedure in order to perform refractive surgery more accurately. The effects of the ablation depth and repair time on the elastic modulus of the rabbit cornea after laser in situ keratomileusis (LASIK) are still unclear. METHODS: In this study, LASIK was performed on New Zealand rabbits with different ablation depth (only typical LASIK flaps were created; residual stroma bed was 50 or 30% of the whole cornea thickness respectively)...
January 17, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28094096/component-columella-augmentation-in-cleft-nose-rhinoplasty-a-preliminary-study
#17
B Bohluli, P Varedi, M Sezavar, S Pakzad, S C Bagheri
The purpose of this study was to evaluate the outcome of a component columella augmentation technique in cleft nose rhinoplasty. This prospective study included rhinoplasty procedures in bilateral cleft nose patients treated by component columella augmentation technique. After surgery, all patients were followed up daily for the first week, and then at 1 month and 6 months postoperative. The following four parameters were assessed: nasal tip projection, infratip lobule length, infratip lobule-to-base distance, and columella-labial angle...
January 13, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28093632/ureterocystoneostomy-in-complex-oncological-cases-with-an-uebelhoer-modified-boari-bladder-flap
#18
Jan P Radtke, Nina Korzeniewski, Johannes Huber, Celine D Alt, Sascha Pahernik, Boris A Hadaschik, Markus Hohenfellner, Dogu Teber
PURPOSE: The study aims to describe the technique and analyze the outcome of an arcuated bladder incision with building of a triangular flap, first described by Uebelhoer (UBBF), as a modification of the classical rectangular Boari bladder flap (BBF), that is often viable, but can present difficulties, such as reduced flap vascularization and mobility in pretreated patients. METHODS: Twelve consecutive patients with distal or mid ureteral leakage or stenosis, that underwent UBBF, were retrospectively analyzed...
January 16, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28092922/the-effectiveness-of-free-vascularized-fibular-flaps-in-osteonecrosis-of-the-femoral-head-and-neck-a-systematic-review
#19
Cassandra A Ligh, Jonas A Nelson, John P Fischer, Stephen J Kovach, L Scott Levin
Background Free vascularized fibular flaps (FVFFs) are accepted surgical options to treat osteonecrosis of the femoral head and neck (ONFHN) to prevent conversion to total hip replacement (THR), yet many studies are single institution cohorts, with little generalizability. Purpose The purpose of this study was to perform a systematic review examining the comparative effectiveness of FVFF to treat ONFHN, particularly preventing conversion to a THR and improving hip function/symptoms. Methods We searched PubMed and EMBASE databases using femoral head, free fibula, and femoral neck keywords...
January 16, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28092337/anatomical-basis-and-clinical-application-of-synovial-flaps-in-the-wrist-and-distal-forearm
#20
David L Colen, Jiun-Ting Yeh, Lawrence B Colen
Neuropathic symptoms after median nerve repair at the wrist or secondary to refractory carpal tunnel syndrome may become debilitating. These symptoms develop due to perineural adhesions, intraneural fibrosis and fixation of the nerve to the transverse carpal ligament after surgery and often require neurolysis. Interposition of vascularized soft tissue over the median nerve at the time of neurolysis prevents recurrence of such adhesions. The synovial flap, fashioned from the synovial lining of the flexor tendon sheath, is an ideal tissue for this purpose...
January 12, 2017: Plastic and Reconstructive Surgery
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