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https://www.readbyqxmd.com/read/28226373/microvascular-flaps-in-nasal-reconstruction
#1
Irene A Kim, Kofi D O Boahene, Patrick J Byrne, Shaun C Desai
Nasal reconstruction for subtotal and total rhinectomy defects is a challenging endeavor, which requires technical finesse, a keen artistic eye, and the ability to anticipate long-term changes that accompany postoperative healing. While local and regional flaps have traditionally been utilized to reconstitute missing nasal elements, certain situations may not provide sufficient or acceptable tissue for optimal reconstruction. In these situations, the three major components of the nose-lining, structural support, and external skin-may require reconstruction with tissues harvested from distant sites through microvascular free tissue transfer...
February 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28226372/reconstruction-of-the-intranasal-lining
#2
Joseph Zenga, John J Chi
Reconstruction of full-thickness nasal defects has been the subject of surgical inquiry and innovation for over 2,000 years. The replacement of the internal nasal lining is a critical feature of complex nasal reconstruction. Successful reconstruction can prevent cicatricial contraction, external distortion, and internal stenosis. An array of reconstructive possibilities has been described, including cutaneous, mucosal, and fascial options. The challenge to the reconstructive surgeon is to select the repair that maximizes internal stability, while maintaining a patent nasal airway, minimizing morbidity, and meeting patient expectations...
February 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28226371/nasal-reconstruction-involving-multiple-subunit-defects
#3
Artemus Cox, Matthew Fort
The challenges of nasal reconstruction are readily apparent to any surgeon who has undertaken this task. Defects involving multiple subunits of the nose usually require adjacent tissue transferred to the wound typically in the form of a forehead flap or other local flaps. Herein, we describe current thought on the subunit principle and the application of local flaps and grafts in reconstructing larger superficial defects of the nose. Primary attention is paid to analysis and patient counseling.
February 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28226368/local-cutaneous-flaps-in-nasal-reconstruction
#4
Guanning Nina Lu, J David Kriet, Clinton D Humphrey
Facial plastic surgeons use a variety of reconstruction techniques to overcome challenges in restoring the function, structural integrity, and intricate nasal contour in nasal reconstruction. Local cutaneous flaps provide excellent skin texture, thickness, and color match in nasal reconstruction. They offer an excellent cosmetic appearance for small- to medium-sized defects and are preferentially utilized when feasible. This article aims to provide an updated review of local cutaneous flaps for nasal defect repair and describe the major principles related to flap selection...
February 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28226365/nasal-anatomy-and-function
#5
Ruchin G Patel
The nose is a complex structure important in facial aesthetics and in respiratory physiology. Nasal defects can pose a challenge to reconstructive surgeons who must re-create nasal symmetry while maintaining nasal function. A basic understanding of the underlying nasal anatomy is thus necessary for successful nasal reconstruction.
February 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28212126/comparison-of-the-speech-results-after-correction-of-submucous-cleft-palate-with-furlow-palatoplasty-and-pharyngeal-flap-combined-with-intravelar-veloplasty
#6
Mert Calis, Galip Gencay Ustun, Mehtap Ozturk, Riza Onder Gunaydin, Mavis Emel Kulak Kayikci, Figen Ozgur
Submucous cleft palate (SMCP) is a relatively rare variant of the common pathology of cleft palate with specific anatomic and clinical features. Even though there are many surgical options defined previously to correct the SMCP, correction of the velopharyngeal insufficiency and obtaining ideal speech results remains as a challenge. The aim of this article was to compare the speech benefits of Furlow double opposing Z plasty and posterior pharyngeal flap operation combined with intravelar veloplasty for the correction of SMCP using objective assessment tools...
February 16, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28210226/combination-of-collagen-based-scaffold-and-bioactive-factors-induces-adipose-derived-mesenchymal-stem-cells-chondrogenic-differentiation-in-vitro
#7
Giovanna Calabrese, Stefano Forte, Rosario Gulino, Francesco Cefalì, Elisa Figallo, Lucia Salvatorelli, Eugenia T Maniscalchi, Giuseppe Angelico, Rosalba Parenti, Massimo Gulisano, Lorenzo Memeo, Raffaella Giuffrida
Recently, multipotent mesenchymal stem cells (MSCs) have attracted much attention in the field of regenerative medicine due to their ability to give rise to different cell types, including chondrocytes. Damaged articular cartilage repair is one of the most challenging issues for regenerative medicine, due to the intrinsic limited capability of cartilage to heal because of its avascular nature. While surgical approaches like chondral autografts and allografts provide symptoms and function improvement only for a short period, MSC based stimulation therapies, like microfracture surgery or autologous matrix-induced chondrogenesis demonstrate to be more effective...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28205501/transseptal-access-with-crossing-multiple-incisions-for-improved-pedicle-control-and-septum-preservation-how-i-do-it
#8
K Omura, D Asaka, J Nayak, Y Tanaka
INTRODUCTION: Recently, the surgical management of nasal tumors has been greatly influenced by advanced endoscopic techniques. To achieve complete endoscopic resection of large obstructing nasal tumors, a sufficient corridor for adequate exposure is also required. In the Japanese language, TACMI means "master expert," and herein we describe an endoscopic technique with novel elements that we term transseptal access with crossing multiple incisions (TACMI). This approach enables a direct transseptal approach to the pedicle through tumor transposition while allowing complete septal reconstruction and stability...
February 15, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28199045/nasal-juvenile-angiofibroma-current-perspectives-with-emphasis-on-management
#9
Fernando López, Asterios Triantafyllou, Carl H Snyderman, Jennifer L Hunt, Carlos Suárez, Valerie J Lund, Primož Strojan, Nabil F Saba, Iain J Nixon, Kenneth O Devaney, Isam Alobid, Manuel Bernal-Sprekelsen, Ehab Y Hanna, Alessandra Rinaldo, Alfio Ferlito
Juvenile angiofibroma is an uncommon, benign, locally aggressive vascular tumor. It is found almost exclusively in young men. Common presenting symptoms include nasal obstruction and epistaxis. More advanced tumors may present with facial swelling and visual or neurological disturbances. The evaluation of patients with juvenile angiofibroma relies on diagnostic imaging. Preoperative biopsy is not recommended. The mainstay of treatment is resection combined with preoperative embolization. Endoscopic surgery is the approach of choice in early stages, whereas, in advanced stages, open or endoscopic approaches are feasible in expert hands...
February 15, 2017: Head & Neck
https://www.readbyqxmd.com/read/28196255/effect-of-2-years-of-treatment-with-sublingual-grass-pollen-immunotherapy-on-nasal-response-to-allergen-challenge-at-3-years-among-patients-with-moderate-to-severe-seasonal-allergic-rhinitis-the-grass-randomized-clinical-trial
#10
Guy W Scadding, Moises A Calderon, Mohamed H Shamji, Aarif O Eifan, Martin Penagos, Florentina Dumitru, Michelle L Sever, Henry T Bahnson, Kaitie Lawson, Kristina M Harris, Audrey G Plough, Joy Laurienzo Panza, Tielin Qin, Noha Lim, Nadia K Tchao, Alkis Togias, Stephen R Durham
Importance: Sublingual immunotherapy and subcutaneous immunotherapy are effective in seasonal allergic rhinitis. Three years of continuous treatment with subcutaneous immunotherapy and sublingual immunotherapy has been shown to improve symptoms for at least 2 years following discontinuation of treatment. Objective: To assess whether 2 years of treatment with grass pollen sublingual immunotherapy, compared with placebo, provides improved nasal response to allergen challenge at 3-year follow-up...
February 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28194635/using-the-slug-mucosal-irritation-assay-to-investigate-the-tolerability-of-tablet-excipients-on-human-skin-in-the-context-of-the-use-of-a-nipple-shield-delivery-system
#11
Richard Kendall, Joke Lenoir, Stephen Gerrard, Rebekah L Scheuerle, Nigel K H Slater, Catherine Tuleu
PURPOSE: Neonates are particularly challenging to treat. A novel patented drug delivery device containing a rapidly disintegrating tablet held within a modified nipple shield (NSDS) was designed to deliver medication to infants during breastfeeding. However concerns exist around dermatological nipple tolerability with no pharmaceutical safety assessment guidance to study local tissue tolerance of the nipple and the areola. This is the first Slug Mucosal Irritation (SMI) study to evaluate irritancy potential of GRAS excipients commonly used to manufacture rapidly disintegrating immediate release solid oral dosage form METHODS: Zinc sulphate selected as the antidiarrheal model drug that reduces infant mortality, was blended with functional excipients at traditional levels [microcrystalline cellulose, sodium starch glycolate, croscarmellose sodium, magnesium stearate]...
February 13, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28191761/angiogenic-potential-of-human-bone-marrow-derived-mesenchymal-stem-cells-in-chondrocyte-brick-enriched-constructs-promoted-stable-regeneration-of-craniofacial-cartilage
#12
Zhiye Li, Ruikai Ba, Zhifa Wang, Jianhua Wei, Yimin Zhao, Wei Wu
Craniofacial deformities caused by congenital defects or trauma remain challenges for clinicians, whereas current surgical interventions present limited therapeutic outcomes. Injection of bone marrow-derived mesenchymal stem cells (BMSCs) into the defect is highly desirable because such a procedure is microinvasive and grafts are more flexible to fill the lesions. However, preventing hypertrophic transition and morphological contraction remain significant challenges. We have developed an "all host derived" cell transplantation system composed of chondrocyte brick (CB)-enriched platelet-rich plasma (P) gel and BMSCs (B)...
February 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28182031/allergies-in-urban-versus-countryside-settings-in-poland-as-part-of-the-epidemiology-of-the-allergic-diseases-in-poland-ecap-study-challenge-the-early-differential-diagnosis
#13
Edyta Krzych-Fałta, Konrad Furmańczyk, Barbara Piekarska, Aneta Tomaszewska, Adam Sybilski, Bolesław K Samoliński
INTRODUCTION: The incidence of allergies depends on a number of factors, including adopting an urban "western" lifestyle, genetic predispositions, and different regions of residence. AIM: To compare the prevalence of allergic conditions (seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR), bronchial asthma (BA), atopic dermatitis (AD)) in a group of countryside versus urban residents in Poland. MATERIAL AND METHODS: The prevalence of allergic conditions in urban versus countryside settings was assessed using the translated and approved questionnaire developed for international ECRHS II and ISAAC studies...
October 2016: Postȩpy Dermatologii i Alergologii
https://www.readbyqxmd.com/read/28175991/spontaneous-cerebrospinal-fluid-leaks-in-the-anterior-skull-base-secondary-to-idiopathic-intracranial-hypertension
#14
Gabriel Martínez-Capoccioni, Ramón Serramito-García, Maria Martín-Bailón, Alfredo García-Allut, Carlos Martín-Martín
Spontaneous cerebrospinal fluid (CSF) leaks represent a clinical entity in which CSF rhinorrhea occurs in the absence of any inciting event. Spontaneous CSF leaks are associated with elevated intracranial pressure (ICP) or have underlying idiopathic intracranial hypertension (IIH). We report a cohort of patients who have undergone nasal endoscopic repair for spontaneous CSF leaks. We review our perioperative complications and the effectiveness of the nasal endoscopic approach to repair spontaneous CSF leaks...
February 7, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28170118/image-guided-interstitial-high-dose-rate-brachytherapy-in-the-treatment-of-inoperable-recurrent-head-and-neck-malignancies-an-effective-option-of-reirradiation
#15
Nikolaos Tselis, Efstratios Karagiannis, Christos Kolotas, Mehran Baghi, Natasa Milickovic, Nikolaos Zamboglou
BACKGROUND: In recurrent head and neck cancer, therapeutic options are limited and high-quality evidence is rare. The purpose of this report was to present our experience of CT-guided interstitial high-dose rate (HDR) brachytherapy in 4 challenging cases of inoperable recurrent head and neck cancer. METHODS: A 53-year-old man with mucosal melanoma of the paranasal sinuses, a 61-year-old man with myofibroblastic sarcoma of the nasal cavity, a 51-year-old woman with nasopharyngeal cancer, and a 44-year-old woman with orbital leiomyosarcoma were treated with reirradiation by HDR brachytherapy after previous comprehensive therapy, including full course external radiotherapy (RT)...
February 7, 2017: Head & Neck
https://www.readbyqxmd.com/read/28166559/should-we-prescribe-antibiotics-to-this-patient-with-persistent-upper-respiratory-symptoms-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#16
Howard Libman, Diane M Brockmeyer, Howard S Gold
The American College of Physicians (ACP) and the Centers for Disease Control and Prevention (CDC) recently published advice for high-value care on the appropriate use of antibiotics for acute respiratory tract infections. They conducted a narrative literature review of evidence for antibiotic use in this setting that included recent clinical guidelines from professional societies supplemented by randomized, controlled trials; meta-analyses; and systematic reviews. They concluded that clinicians should reserve antibiotic treatment for acute rhinosinusitis in patients with persistent symptoms for more than 10 days, high fever and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or worsening symptoms after a typical viral illness that lasted 5 days and had initially improved ("double-sickening")...
February 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28145824/intranasal-delivery-of-nanoparticle-based-vaccines
#17
Nirmal Marasini, Mariusz Skwarczynski, Istvan Toth
Most pathogens gain access to the human body and initiate systemic infections through mucosal sites. A large number of currently marketed licensed vaccines are parenterally administered; they generate strong systemic immunity but not mucosal immunity. Nasal vaccination is an appealing strategy for the induction of mucosal-specific immunity; however, its development is mostly challenged by several factors, such as inefficient antigen uptake, its rapid mucociliary clearance, size-restricted permeation across epithelial barriers and absence of safe human mucosal adjuvants...
January 2017: Therapeutic Delivery
https://www.readbyqxmd.com/read/28139053/anti-inflammatory-effects-of-the-petasin-phyto-drug-ze339-are-mediated-by-inhibition-of-the-stat-pathway
#18
Sabrina A Steiert, Ulrich M Zissler, Adam M Chaker, Julia Esser-von-Bieren, Daniela Dittlein, Ferdinand Guerth, Constanze A Jakwerth, Guido Piontek, Catherine Zahner, Juergen Drewe, Claudia Traidl-Hoffmann, Carsten B Schmidt-Weber, Stefanie Gilles
Ze339, an herbal extract from Petasites hybridus leaves is effective in treatment of allergic rhinitis by inhibition of a local production of IL-8 and eicosanoid LTB4 in allergen-challenged patients. However, the mechanism of action and anti-inflammatory potential in virally induced exacerbation of the upper airways is unknown. This study investigates the anti-inflammatory mechanisms of Ze339 on primary human nasal epithelial cells (HNECs) upon viral, bacterial and pro-inflammatory triggers. To investigate the influence of viral and bacterial infections on the airways, HNECs were stimulated with viral mimics, bacterial toll-like-receptor (TLR)-ligands or cytokines, in presence or absence of Ze339...
January 31, 2017: BioFactors
https://www.readbyqxmd.com/read/28138053/progressive-perforation-of-the-nasal-septum-due-to-leishmania-major-a-case-of-mucosal-leishmaniasis-in-a-traveler
#19
Nicole Harrison, Julia Walochnik, Reinhard Ramsebner, Luzia Veletzky, Heimo Lagler, Michael Ramharter
This report describes a case of mucosal leishmaniasis caused by Leishmania major with destructive perforation of the nasal septum illustrating the diagnostic challenges of a rare clinical presentation of L. major infection in a traveler. The atypical presentation may have been associated with the use of cortisone as a potential trigger for the progressive destruction of the nasal septum.
January 30, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28129808/cystic-fibrosis-diagnostic-challenges-over-4-decades-historical-perspectives-and-lessons-learned
#20
Philip M Farrell, Terry B White, Nico Derichs, Carlo Castellani, Beryl J Rosenstein
OBJECTIVE: Because cystic fibrosis (CF) can be difficult to diagnose, and because information about the genetic complexities and pathologic basis of the disease has grown so rapidly over the decades, several consensus conferences have been held by the US CF Foundation, and a variety of other efforts to improve diagnostic practices have been organized by the European CF Society. Despite these efforts, the application of diagnostic criteria has been variable and caused confusion. STUDY DESIGN: To improve diagnosis and achieve standardization in terms and definitions worldwide, the CF Foundation in 2015 convened a committee of 32 experts in the diagnosis of CF from 9 countries...
February 2017: Journal of Pediatrics
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