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Early management can reduce the risk of permanent neurosensory deficits.
Congenital or secondary deficiency in septal cartilage leads to an unpleasant cosmetic appearance and compromised function as well. Rhinoplasty maneuvers such as spreader graft and septal extension graft with autologous tissue have been exhibited to correct the deformities. However, the relatively severe donor site morbidity stands as a main concern for both surgeons and patients.
From January of 2014 to April of 2018, 52 patients presenting septal deformities underwent rhinoplasty with our modified technique. A piece of Medpor (8438) was tailored, folded and then placed as a combination of spreader and septal extension graft. The surgical outcomes were evaluated both objectively and subjectively.
All the patients were followed up for 12 to 24 months postoperatively. The ratio of tip projection and the nasal length exhibited significant improvement in all our patients. Nasal obstruction subjectively mended among the 24 patients who had airway obstruction complaint preoperatively. Only 2 patients had severe adverse events and the implants were removed instantly.
With our modified technique, Medpor proved to be an effective and reliable material for the reconstruction of septal cartilage, which provides us an alternative way to achieve extended spreader and septal extension graft with one single implant in the correction of saddle nose.
Level IV, therapeutic study.
Level IV, therapeutic study.Restoring the nasal lining is a great challenge in the reconstruction of nasal defects. In this series, the authors present our experience in using the upper buccal musculomucosal (UBMM) flap for the reconstruction of full thickness columellar or nasal lining defects. Ten patients who underwent UBMM flap reconstruction of columellar or nasal lining defects, with or without composite grafting, were identified between December of 2014 and February of 2017. The records were retrospectively reviewed to determine the demographics, nasal deformity etiology, surgical technique, complications, flap survival rate and duration of follow-up. Of these ten patients, three were men, and seven were women; the average age was 48.1 years (range, 34-66 years). RMC6236 Four patients underwent bilateral UBMM flaps, and 6 patients underwent unilateral UBMM flap reconstruction. All of the donor sites were closed without complications, except for one small granuloma that occurred 8 months later. Of the total 14 flaps, 7 healed well, 6 healed well after minimal debridement in the clinic, and one failed and was replaced with a contralateral UBMM flap. The average follow-up time was 20.1 months (range, 8-38 months). All patients had satisfactory aesthetic and functional outcomes. Due to the limited availability of healthy local tissue for nasal lining reconstruction after multiple surgeries, the UBMM flap serves as an applicable choice to restore columellar or nasal lining defects, with minimal donor site morbidity and no visible external scarring.Intraconal orbital hidrocystoma is a very rare entity. Herein, a 6-month old boy with an intraconal apocrine hidrocystoma will be reported. The patient presented with a left-sided mild proptosis and significant anisometropic hypermetropia. Clinical examinations revealed choroidal folds and optic disc blurring in the left eye. Orbital MRI disclosed an intraconal well-defined cystic lesion that was hypointense in T1 and hyperintense in T2 weighted images. The lesion was excised completely through a lateral orbitotomy and diagnosed histologically as an apocrine hidrocystoma. Excepting partial improvement of anisometropia, other clinical signs were improved after surgery.Balsam of Peru (BOP) is a naturally occurring, aromatic resinous exudate collected from the Salvadorian tree Myroxolon balsamum pereirae. Studies have shown that the sap of the tree has antimicrobial properties, vasodilatory effects, and promotes healing. Some plastic surgeons use BOP as a topical dressing overlying a reconstructed cleft palate. The current historical manuscript provides a summary of the origin and uses of BOP for medicinal purposes and its current potential beneficial use in plastic surgery as it relates to palatoplasty.
Preoperative three-dimensional computed tomography is currently the gold standard imaging modality in patients with craniofacial anomalies. In these patients, bone structural evaluation is paramount for surgical planning and evaluation of brain parenchyma is often secondary. With the significant complexity of these patients, a majority of patients undergo multiple Computed Tomography (CT) studies from infancy into adulthood. This study presents an ultra-low-dose CT protocol that limits the radiation exposure per CT scan in patients with craniofacial anomalies.
A total of 200 consecutive patients who underwent head CT for preoperative evaluation of craniofacial anomalies at Tertiary Children's Hospital were included in the study. The kVp, (KiloVoltage Peak) mA (milliAnperage), CT dose index (CTDI), and dose-length product (DLP) were documented from the dose page. Patients were stratified based on age for determining age specific effective dose and for age matched comparison. The age specific effective doseotocol provided appropriate diagnostic images with a significantly decreased radiation dose.
Compared to the regular low-dose protocol, the ultra-low-dose CT protocol provided appropriate diagnostic images with a significantly decreased radiation dose.
To explore a new surgical treatment for infection and obstruction of ventriculoperitoneal shunt in hydrocephalus. Two cases of post-operative infection of ventriculoperitoneal shunt were analyzed retrospectively. One case was cryptococcal infection, the other case was Acinetobacter lwoffii. The number of cerebrospinal fluid cells was high, the infection of ventriculoperitoneal shunt was generally complicated with abdominal obstruction, and the hydrocephalus was aggravated again, The authors try to pull out the drainage tube at the end of abdominal cavity for external drainage, combined with intravenous antibiotics, completely control of infection, and then use the original shunt device for intraventricular jugular shunt. The authors explore that this method is simple, safe and effective, and it is an effective and feasible method for the treatment of infection after ventriculoperitoneal shunt.
To explore a new surgical treatment for infection and obstruction of ventriculoperitoneal shunt in hydrocephalus. Two cases of post-operative infection of ventriculoperitoneal shunt were analyzed retrospectively.
Homepage: https://www.selleckchem.com/products/rmc-6236.html
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