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Scalp flaps

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https://www.readbyqxmd.com/read/29138975/distal-transsylvian-keyhole-approach-for-unruptured-anterior-circulation-small-aneurysms
#1
Ririko Takeda, Hiroki Kurita
BACKGROUND: To reduce complications associated with conventional pterional craniotomy, a transsylvian keyhole approach for unruptured small anterior circulation aneurysms is proposed. METHODS: A 7-cm linear scalp incision is made along the hairline, beginning at the zygoma, followed by minimal temporal muscle dissection. Two burr holes are drilled out at McCarty's point and the temporal bone, and a 3-cm equilateral triangle bone flap is made, whose apex is located above the sylvian point...
November 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29119877/direct-puncture-onyx-embolization-of-a-large-calvarial-metastasis-with-intracranial-extension-case-report
#2
Minerva H Zhou, Gavin P Dunn, Joshua W Osbun, DeWitte T Cross, Christopher J Moran, Ralph G Dacey, Akash P Kansagra
We report a case of renal cell carcinoma (RCC) metastasis to the calvarium and describe a strategy for percutaneous embolization of hypervascular calvarial tumors with intracranial extension. An elderly patient with history of RCC presented with left-sided weakness. Imaging studies showed a large right frontoparietal calvarial mass with intra- and extracranial extension. The tumor was devascularized by direct puncture tumor embolization using Onyx 18, allowing subsequent operative resection without significant blood loss or the need for flap reconstruction of the scalp...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29114294/evisceration-of-brain-an-unusual-case-report-of-bear-mauling-from-eastern-india
#3
Bikash Ranjan Behera, Sanjib Mishra, Deepak Das, Rajesh Gantayat
Even if human beings are the most intelligent among all living beings, they are still not immune to attack from wild animals. Human contact with bears has become more frequent as their habitat is being endangered by frequent deforestation. The sloth bear is one of the few bear species found in India, especially in the hilly areas of Southern Odisha. Bears are highly intelligent and omnivorous animals with long claws coupled with powerful shoulder. Here, we describe the tale of a poor tribal male's encounter with a sloth bear resulting in critical injuries to face, scalp, skull bone, with brain matter fungating-out of the skull...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29102755/matriderm%C3%A2-for-the-management-of-scalp-necrosis-following-surgical-treatment-of-a-giant-parietal-encephalocele-case-report
#4
M D Vilela, Has Pedrosa, Fd Sampaio, L J Carneiro
BACKGROUND: management of encephaloceles is challenging when massive brain herniation is present. In such instances, an expansile cranioplasty may be attempted so as to preserve some herniated brain tissue. Complications such as wound dehiscence, CSF leak and scalp necrosis are postoperative concerns. The treatment of scalp necrosis with dural and brain exposure is certainly a challenge, due to the complexity of flap techniques in such a young age. Herein we describe the use of a novel technique for the management of a scalp necrosis and dehiscence in an infant...
November 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29090200/cranial-defect-overlying-a-ventriculoperitoneal-shunt-pressure-gradient-leading-to-free-flap-deterioration
#5
Jae Doo Joo, Jin-Uk Jang, Hyonsurk Kim, Eul-Sik Yoon, Dong Hee Kang
We report a case of free flap deterioration which may have been induced by pressure gradient resulting from cranial defect overlying a ventriculoperitoneal shunt (VP shunt). The patient, male and aged 78, had a VP shunt operation for progressive hydrocephalus. Afterwards, the scalp skin flap surrounding the VP shunt collapsed and showed signs of necrosis, exposing part of the shunt catheter. After covering the defect with a radial forearm free flap, the free flap site showed signs of gradual sinking while the vascularity of the flap remained unimpaired...
September 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/29080894/posttraumatic-intralaminar-hematoma-developing-between-cranial-dural-layers-a-case-report
#6
Biji Bahuleyan, Vineetkumar Thakorbhai Patel, Prashanth Usurumarthi, Girish Kuranjiyoor Madhavan, Santhosh George Thomas
We present a case of post-traumatic hematoma developing between the 2 layers of the cranial dura in a 2-year-old child following head injury. This child presented with history of fall from a height in altered sensorium with paucity of movements on the left side. Computerized tomography scan of the brain showed a right parietal linear fracture with an underlying hyperdense biconvex hematoma. Emergency evacuation of the hematoma was done. On elevation of the scalp flap, a fibrous membrane was seen protruding between the fracture lines...
October 28, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29074315/basal-cell-carcinoma-of-the-scalp-with-destruction-and-invasion-into-the-calvarium-and-dura-mater-report-of-7-cases-and-review-of-literature
#7
Churl-Su Kwon, Omar Al Awar, Valeria Ripa, Ghassan Said, Saulius Rocka
Basal cell carcinoma (BCC) is the most common skin malignancy in humans. Giant BCC is a rarer entity that is characterised by aggressive biological behaviour. Intracranial invasion by a BCC on the scalp is extremely rare. The gold standard treatment of BCCs is represented by surgical excision with a wide variety of reconstructive techniques. In this paper, we describe the largest series to date of recurrent BCCs with intracranial extension involving the dura mater. We report recurrent giant BCC of the scalp with dura mater invasion in 7 patients...
October 23, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29062647/anatomical-study-of-perfusion-of-a-periosteal-flap-with-a-lateral-pedicle
#8
Boktae Kim, Yoshikazu Inoue, Nobuaki Imanishi, Hak Chang, Yusuke Shimizu, Takayuki Okumoto, Kazuo Kishi
BACKGROUND: Pedicled periosteal flaps are commonly used for tissue defects between the base of the skull and the midfacial area. This study aimed to clarify the 3-dimensional vascular distribution of temporal region flaps. METHODS: Ten fresh cadavers were used. Full-thickness cranial flaps were elevated from the cranial bone and each layer was detached separately. Contrast enhancement of the full thickness of the scalp, macroscopic evaluation, and histologic analyses were performed...
September 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29056023/-effects-of-improved-v-y-advancement-flap-with-major-artery-perforator-on-repairing-skin-and-soft-tissue-defects
#9
S T Zhou, M T Huang, J Z Zeng, P F Liang, M H Zhang
Objective: To explore the effect of improved V-Y advancement flap with major artery perforator on repairing several skin and soft tissue defects in whole body. Methods: From March 2015 to June 2017, 4 cases with pressure ulcer in sacrococcygeal region, 4 cases with pressure ulcer at ischial tuberosity, 2 cases with scalp and skull defects at occiput, 1 case with secondary wound after tumor resection in axillary region, and 2 cases with skin and soft tissue defects caused by other trauma were hospitalized, with disease duration ranging from 1 week to 6 months...
October 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29036023/percutaneous-mesh-expansion-pme-a-regenerative-wound-closure-alternative
#10
Kimberly S Khouri, Eufemiano Cardoso, Roger K Khouri
BACKGROUND: Puncture wounds in the 1-mm range usually heal without scars. Stacking rows of these punctures offers a scarless method to generate tissue by mesh expansion. We developed a percutaneous mesh expansion (PME) procedure and present our experience for its wound closure application. METHODS: Over a six-year period we applied PME to 65 consecutive patients 58-101 years-old (mean, 72) with 67 full thickness calvarial defects 2.5x3-7x8cm (mean, 14cm2) that would have all required flaps for closure...
October 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29029236/first-in-human-experience-with-complete-integration-of-neuromodulation-device-within-a-customized-cranial-implant
#11
Chad R Gordon, Gabriel F Santiago, Judy Huang, Gregory K Bergey, Shuya Liu, Mehran Armand, Henry Brem, William S Anderson
BACKGROUND: Neuromodulation devices have the potential to transform modern day treatments for patients with medicine-resistant neurological disease. For instance, the NeuroPace System (NeuroPace Inc, Mountain View, California) is a Food and Drug Administration (FDA)-approved device developed for closed-loop direct brain neurostimulation in the setting of drug-resistant focal epilepsy. However, current methods require placement either above or below the skull in nonanatomic locations. This type of positioning has several drawbacks including visible deformities and scalp pressure from underneath leading to eventual wound healing difficulties, micromotion of hardware with infection, and extrusion leading to premature explantation...
October 6, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28984660/selective-scalp-nerve-block-a-useful-technique-with-tissue-expansion-in-postburn-pediatric-alopecia
#12
Maha Ahmed Abo-Zeid, Alaa Eldin Adel Elmaddawy, Mohamed Hassan El-Fahar, Ahmed Hassan El-Sabbagh
BACKGROUND: Scalp defects can be reconstructed either with skin graft, local flaps, free flaps, or tissue expansion. Tissue expanders have been proved to be fruitful in the pediatric population. Scalp expansion has proved to be useful in the reconstruction of posttraumatic and postburn alopecic defects. Selective nerve block can be added for attenuation of sympathetic stimulation and decrease surgical stress in cranial surgeries. In this study, a comparison was done between using selective nerve block and without selective nerve block in both stages of tissue expansion procedure...
October 3, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28968319/a-novel-reverse-periauricular-flap-reconstruction-method-that-uses-additional-anastomosis-to-avoid-venous-congestion-for-periorbital-defects
#13
Hui Xiao, Haiping Wang
The aim of this study was to introduce and evaluate a method to prevent venous congestion in periauricular flap pedicled on the frontal branch of the superficial temporal artery (STA). Flaps based on the STA are therefore extremely versatile in reconstruction of the face and scalp. The literature on reconstructive possibilities provided by temporal flaps describes venous congestion, but there are currently no methods for preventing this problem. In this brief report, we describe a method to anastomose the parietal branch of superficial temporal vein and the middle temporal vein to ensure venous flow when a concomitant vein of the frontal branch of the STA is unavailable...
September 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28946179/bone-flap-elevation-for-intracranial-eeg-monitoring-technical-note
#14
Yasunori Nagahama, Brian J Dlouhy, Daichi Nakagawa, Janina Kamm, David Hasan, Matthew A Howard, Hiroto Kawasaki
Intracranial electroencephalography (iEEG) provides invaluable information in determining seizure focus and spread due to its high spatial and temporal resolution, which are not afforded by noninvasive studies. Electrodes of various types (e.g., grid, strip, and depth electrodes) and configurations are often used for optimum coverage of suspected areas of seizure onset and propagation. Given the fixed intracranial volume and added mass effect from placement of cortical electrodes, brain edema and postoperative deficits can occur...
September 15, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28944938/-reverse-j-shaped-skin-flap-and-cranial-bone-groove-for-shunt-hardware-a-new-technique-in-patients-with-fragile-skin
#15
Murteza Cakir
INTRODUCTION: Shunt systems are not perfect devices and can cause severe complications. Complications may originate from problems related to the valve, the patient, or the surgery and more common in neonates, infants, especially preterm by reason of the special characteristics these patients owned. We therefore have succesfully developed useful and viable surgical technique in order to provide helpful aspects to surgical issues mentioned above. TECHNIQUE: This technique includes \"reverse J\" shaped skin incision with nonintersecting the shun's hardware and distal catheter and to be reduced the wound problems to the minimum rates by opening \"bone groove\"...
July 11, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28938330/temporal-scalp-thickness-body-mass-index-and-suprafascial-placement-of-receiver-coil-of-the-cochlear-implant
#16
Orhan Ozturan, Alper Yenigun, Erol Senturk, Omer Faruk Calim, Fadlullah Aksoy, Sabri Baki Eren
OBJECTIVE: The objectives of this study are to demonstrate the relationship between the thickness of the temporal scalp and body mass index (BMI), age, and sex, and to present the surgical technique which we perform in patients with a thick scalp. MATERIALS AND METHODS: This is a retrospective, cross-sectional study. This study was performed in a tertiary referral center. Cranial computed tomography images of 469 subjects were included in the study. These subjects were evaluated according to BMI, age, and sex...
November 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28937303/palliative-coverage-of-cranial-defect-following-failed-cranial-flap-for-advanced-squamous-cell-carcinoma-case-report
#17
Vyacheslav Makler, Jeffrey S Litt, N Scott Litofsky
INTRODUCTION: With advanced-stage head and neck cancers, patients may develop large and/or complex wounds despite multiple reconstruction attempts. Wound coverage may require novel approaches to palliate the patient. METHOD: We present the case of a 56-year-old female with advanced squamous cell carcinoma of the scalp and skull who required multiple surgical interventions. Despite our best reconstructive efforts, the patient subsequently developed scalp infection and sepsis, necessitating further debridement for source control...
September 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28913317/reconstruction-of-a-complex-scalp-defect-after-the-failure-of-free-flaps-changing-plans-and-strategy
#18
Youn Hwan Kim, Gyeong Hoe Kim, Sang Wha Kim
The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neurosurgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft...
June 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28913291/immediate-near-total-scalp-reconstruction-with-artificial-dermis-on-exposed-calvarium
#19
Sooyeon Park, Ki Taik Han, Min Cheol Kim, Jin Soo Lim
Scalp defect management is complicated secondary to reduced laxity in the scalp and forehead area. For reconstruction of larger defects with exposed bone and loss of the periosteal layer, free flap reconstruction is one option for single-stage surgery, although the procedure is lengthy and includes the possibility of flap loss. We successfully performed a single-stage reconstruction of a large scalp defect using a combination of artificial dermis, split-thickness skin graft, and full-thickness skin graft following wide excision of a cutaneous angiosarcoma, and present our method as one option for the treatment of large oncologic surgical defects in patients who are poor candidates for free flap surgery...
December 2016: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28911959/histological-changes-in-the-periosteum-following-subperiosteal-expansion-in-rabbit-scalp
#20
Mohamad Taghi Kiani, Nasrin Takzare, Ahad Khoshzaban, Elahe Jalilianfar, Leila Aghajanpour, Reza Tabrizi
PURPOSE: In intraoral bone grafting, tension-free coverage of the recipient site with periosteal flap results in optimal wound closure. Tissue expansion could be a suitable modality to obtain soft tissue in the oral cavity. The aim of this study was to assess the histology of the periosteum after subperiosteal expansion in the rabbit scalp. MATERIALS AND METHODS: In this animal study, 6 rectangular tissue expanders were placed in the skulls of 6 male white New Zealand rabbits; in 6 control rabbits, an incision was made to the periosteum but no expansion was performed...
August 31, 2017: Journal of Oral and Maxillofacial Surgery
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