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Mary In-Ping Huang Cobb, Rachael Mintz-Cole, Aatif M Husain, Miles Berger, David Jang, Patrick Codd
BACKGROUND: Prolactinomas are typically treated non-surgically with a dopamine agonist. However, once the tumor shrinks, adjacent eloquent structures such as the optic apparatus can become skeletonized and herniate into the dilated parasellar space. CASE DESCRIPTION: We describe here a 48-year-old man with a prolactin-secreting macroadenoma treated with cabergoline who presented with progressive bitemporal hemianopsia. MRI showed no recurrence of disease and a stretched optic chiasm herniating into an empty sella...
February 5, 2018: World Neurosurgery
Mitchell R Gore
Background: Lateral sphenoid encephaloceles present a surgical challenge. These encephaloceles may be difficult to access given their lateral location and proximity to the neural and vascular structures of the sphenoid floor, pterygopalatine fossa, and lateral and superior sphenoid walls. Additionally, many patients have idiopathic intracranial hypertension, increasing the risk of recurrence. When untreated or undiscovered, these encephaloceles increase the risk of meningitis. Methods: All consecutive endoscopic repairs of lateral sphenoid encephaloceles by a single surgeon from 2012 to 2017 were analyzed for method of repair, complications, and recurrence rate...
2017: BMC Ear, Nose, and Throat Disorders
Corey T Walker, M Yashar S Kalani, Mark E Oppenlander, Jakub Godzik, Nikolay L Martirosyan, Robert J Standerfer, Nicholas Theodore
OBJECTIVE The authors report a novel paradigm for resection of the disc or dural complex to treat giant calcified transdural herniated thoracic discs, and they describe a technique for the repair of dural defects. These herniated thoracic discs are uncommon, complicated lesions that often require a multidisciplinary team for effective treatment. The intradural component must be removed to effectively decompress the spinal cord. The opening of the friable dura mater, which frequently adheres to the extradural component of the disc, can result in large defects and difficult-to-manage CSF leaks...
February 2018: Journal of Neurosurgery. Spine
Glyn Jones, Aran Yoo, Victor King, Brian Jao, Huaping Wang, Charalambos Rammos, Eric Elwood
BACKGROUND: Staged subpectoral expander-implant breast reconstruction is widely performed. Disruption of the pectoralis major origin and the frequent occurrence of animation deformity and functional discomfort associated with subpectoral reconstruction remain ongoing concerns. Prepectoral single-stage direct-to-implant reconstruction resolves many of these issues. In this study, the authors explored the rationale for prepectoral single-stage implant-based breast reconstruction with anterior AlloDerm coverage as an alternative to the staged approach...
December 2017: Plastic and Reconstructive Surgery
Ioannis T Konstantinidis, William Chu, Federico Tozzi, Clayton Lau, Mark Wakabayashi, Kevin Chan, Byrne Lee
BACKGROUND: Robotic-assisted total pelvic exenteration (TPE) can offer a minimally invasive approach to a major multi-organ operation. METHODS: In this video, we summarize a stepwise approach to robotic TPE in a 70 year-old female Jehovah's witness with a history of cervical cancer post-chemoradiation and radical hysterectomy who experienced local recurrence at the vaginal cuff involving the rectum and bladder. RESULTS: The patient was placed in the lithotomy position...
August 14, 2017: Annals of Surgical Oncology
S J Park, Y Kim, S Y Jang
PurposeTo describe the use of an acellular dermal allograft (AlloDerm) for patients with insufficient conjunctiva during evisceration and implantation surgery.Patients and methodsThe medical records of six patients with insufficient conjunctiva during evisceration surgery were reviewed. It was not possible to close the Tenon's capsule and conjunctiva without wound tension in these patients, so AlloDerm was placed over the sclera, and the edges were sutured with adjacent conjunctiva without tension. The size of the bare AlloDerm graft was measured in all patients...
August 11, 2017: Eye
Shiuhyang Kuo, Hyungjin Myra Kim, Zhifa Wang, Eve L Bingham, Atsuko Miyazawa, Cynthia L Marcelo, Stephen E Feinberg
Immunologically inert allogeneic acellular dermal scaffolds provide a matrix with molecular architecture close to native tissues, which synthetic scaffolds cannot. Not all nature-derived scaffolds possess the same biological and physical properties. The different properties of scaffolds supporting cellular growth used for manufacturing tissue engineered grafts could lead to different implantation results. The scaffold properties should be carefully considered in order to meet the expected outcomes of tissue engineered grafts...
July 28, 2017: Journal of Tissue Engineering and Regenerative Medicine
Michael Zenn, Mark Venturi, Troy Pittman, Scott Spear, Geoffrey Gurtner, Geoffrey Robb, Alex Mesbahi, Joseph Dayan
Background: This article reports on the current use of acellular dermal matrix in breast reconstruction. Methods: A literature review of articles on acellular dermal matrix in breast reconstruction from January 1, 2010, through December 20, 2016, was performed and analyzed for trends in acellular dermal matrix use and differences between commonly used acellular dermal matrixes. Findings: Clinical findings varied but include improved cosmesis and more 1-stage reconstructions using acellular dermal matrix. Superiority of sterile versus aseptic acellular dermal matrixes was noted, and the increased incidence of red breast syndrome with AlloDerm was significant...
2017: Eplasty
Christine U Lee, Aleh Bobr, Jorge Torres-Mora
Acellular dermal matrix (ADM) such as Alloderm(®) is sometimes used in tissue reconstruction in primary and reconstructive breast surgeries. As ADM is incorporated into the native tissues, the evolving imaging findings that would correlate with varying degrees of host migration and neoangiogenesis into the matrix can be challenging to recognize. In the setting of a palpable or clinical area of concern after breast reconstructive surgery following breast cancer, confident diagnosis of a mass representing ADM rather than recurring or developing disease can be challenging...
2017: Journal of Clinical Imaging Science
Kyeong-Tae Lee, Goo-Hyun Mun
BACKGROUND: The current diversity of the available acellular dermal matrix (ADM) materials for implant-based breast reconstruction raises the issue of whether there are any differences in postoperative outcomes according to the kind of ADM used. The present meta-analysis aimed to investigate whether choice of ADM products can affect outcomes. METHODS: Studies that used multiple kinds of ADM products for implant-based breast reconstruction and compared outcomes between them were searched...
July 2017: Annals of Plastic Surgery
Edward I Chang, Jun Liu
BACKGROUND: The use of acellular dermal matrix (ADM) has become the standard of care in breast reconstruction. However, the majority of current studies are biased or combine large databases introducing inherent flaws. Here, we present a prospective single surgeon experience comparing three ADM. METHODS: All expander based breast reconstructions between 2014 and 2015 using ADM were included. RESULTS: Eighteen patients (32 breasts) underwent reconstruction using Flex Pliable, 15 patients (22 breasts) used Alloderm, and 14 patients (20 breasts) had Dermacell...
September 2017: Journal of Surgical Oncology
Rajeev Chaudhry, Katherine M Theisen, Pankaj P Dangle, Francis X Schneck
Phallic reconstruction is an important part of management for congenital aphallia. Scrotal flap phalloplasty has been described in pediatric patients to create the appearance of a nonfunctioning phallus. We describe a modified scrotal flap technique with the addition of an acellular dermal matrix patch (AlloDerm) to provide additional girth and support to the phallus. The postoperative cosmetic outcome has been satisfactory and there is no documented complication over a 12-month follow-up. AlloDerm dermal matrix can be a safe addition to phallic reconstruction and its overall application needs to be further studied...
April 12, 2017: Urology
Katharine M Hinchcliff, Hakan Orbay, Brittany K Busse, Heath Charvet, Mankushpreet Kaur, David E Sahar
AlloDerm RTU(®) and AlloMaxTM are two acellular dermal matrices (ADMs) used in implant-based breast reconstruction. In this study, we examined whether different processing methods for the ADMs lead to a disparity in histologic, clinical, and financial outcomes after breast reconstruction. Thirty patients undergoing implant-based breast reconstruction were randomized into AlloMax or AlloDerm arms (n = 15, each). ADM was placed at the time of immediate reconstruction. Patients were evaluated for complications on postoperative days 7, 14, and 30...
May 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Frederick Yoo, Marilene B Wang, Marvin Bergsneider, Jeffrey D Suh
Objectives Bilateral anterior skull base (ASB) defects following endoscopic endonasal tumor resection are most commonly repaired utilizing multilayered reconstruction with a vascularized mucosal flap. Single-layer closure of large ASB defects has been described in the literature but this technique has yet to gain a widespread use. We report our experience with a series of patients who underwent reconstruction of large ASB defects using a single-layer intradural graft, without nasoseptal flaps. We also compared the use of acellular dermal matrix (AlloDerm, LifeCell, Branchburg, New Jersey, United States) or collagen matrix xenograft (Duramatrix, Stryker, Kalamazoo, Michigan, United States) as the graft biomaterial...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
William D Bolton, Sharon Ben-Or, Allyson L Hale, James E Stephenson
This case describes successful reconstruction of a long-segment tracheal defect using AlloDerm as the conduit for reconstruction. A 38-year-old woman who had undergone a thyroid lobectomy in 2011 presented several months later unable to swallow. Chest computed tomography results revealed a tracheal/esophageal mass and a subsequent bronchoscopy, and esophagogastroduodenoscopy results revealed an upper esophageal/tracheal mass with two areas concerning for fistula. She underwent a bronchoscopy with a tracheal stent and percutaneous endoscopic gastrostomy placement...
March 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Alice Woo, Christin Harless, Steven R Jacobson
Significant advances have been made to the reconstructive tools available to plastic surgeons allowing for the re-exploration of subcutaneous breast reconstruction. The purpose of the current study is to examine the safety, efficacy, and aesthetic results of subcutaneous breast reconstruction by a single-surgeon. A retrospective chart review was performed on all patients undergoing subcutaneous implant-based breast reconstruction between April 2012 and September 2014. All implants were fully wrapped in Alloderm and placed in the subcutaneous (pre-pectoral) plane...
September 2017: Breast Journal
James C Yuen, Cathryn A Coleman, Stephen W Erickson
With a population in which 70% of the patients were overweight or obese, we reviewed retrospectively 135 breasts of 70 consecutive patients who underwent implant-based immediate breast reconstruction using freeze-dried AlloDerm as the acellular dermal matrix. Several obesity-related parameters were evaluated to determine their possible correlation to early postoperative complications. We found that breast width and surface area of AlloDerm usage correlated with the development of infection and mastectomy skin flap necrosis...
February 2017: Plastic and Reconstructive Surgery. Global Open
Kutluk Oktay, Enes Taylan, Yodo Sugishita, Gabriela M Goldberg
STUDY OBJECTIVE: To show a new approach for orthotopic human ovarian tissue transplantation via robot-assisted laparoscopic surgery. DESIGN: A step-by-step video explanation of the surgical technique (Canadian Task Force classification III). SETTING: Academic medical center. INTERVENTIONS: The robot-assisted transplantation approach consisted of 3 steps: (1) reconstruction of the ovarian tissue graft, (2) preparation of the contralateral menopausal ovary as the recipient site, and 3) transplantation of the reconstructed graft to the bivalved contralateral ovary...
March 6, 2017: Journal of Minimally Invasive Gynecology
Shaun D Mendenhall, Layla A Anderson, Jian Ying, Kenneth M Boucher, Leigh A Neumayer, Jayant P Agarwal
BACKGROUND: The Breast Reconstruction Evaluation of Acellular Dermal Matrix as a Sling Trial is a prospective randomized trial comparing outcomes of tissue expander breast reconstruction using either AlloDerm or DermaMatrix. The trial was divided into 3 outcome stages; this study reports stage II outcomes, which are those from the time of definitive reconstruction to 3 months postoperative. METHODS: A randomized trial was conducted to compare complication rates between AlloDerm and DermaMatrix groups...
January 2017: Plastic and Reconstructive Surgery. Global Open
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...
May 2017: American Journal of Otolaryngology
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