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2020 Connect Editors.
3% of patients, hoarseness in 36.2% of patients, and laryngospasm in 1.4% of patients. Of patients that had postoperative hoarseness, 96% had resolution within 20 days. In our patient's case, chondrolaryngoplasty was performed with a tracheal shave in combination with high-speed burring for fine contouring. FHD-609 in vivo The patient experienced hoarseness for 1 week postoperatively that self-resolved. Conclusion Overall, chondrolaryngoplasty for reduction of the thyroid cartilage appears to be a safe and effective procedure. The complications that occurred in identified case series were mild and self-limiting. Although serious complications are certainly possible, we were not able to identify their occurrence in the literature. Recent modifications in chondrolaryngoplasty involve protecting the anterior commissure tendon to prevent iatrogenic voice modification. © 2019 The Author(s).Acellular dermal matrix (ADM) has become an accepted and advantageous adjunct to alloplastic breast reconstruction. The increase in demand has led to an upsurge of dermal-based products, both human and animal derived. There are few direct ADM comparative studies, but it is unclear whether there are any differences in complication rates. Our primary objective was to determine whether there is a difference in outcomes between AlloDerm and DermACELL in immediate alloplastic breast reconstruction. A retrospective chart review of those who underwent immediate alloplastic breast reconstruction from January to December 2016 was performed. This encompassed 64 consecutive patients (95 breasts) with tissue expander or direct-to-implant reconstruction and either AlloDerm or DermACELL ADM. Demographics, particulars of the surgery, additional treatments and complications were all recorded. Differences in seroma, haematoma and infection rates, as well as more serious complications including implant replacement, capsular contracture and failure, were all reviewed. The groups were comparable in terms of age, BMI and relevant comorbidities. Mastectomy weight and resulting implant volume were higher in the DermACELL group, with volume reaching statistical significance (p = 0.001). With an average follow-up of 18 months, there was no difference in capsular contraction or implant replacement. However, in those who developed capsular contracture in the DermACELL group, more breasts had no history of radiation, which was significant (p = 0.042). Overall, there were no significant differences in complication rates of seroma, haematoma, mastectomy flap necrosis and infection. © 2019 The Authors.Introduction Several variations on the surgical technique for macrostomia repair have been described in the literature. There has been controversy regarding the preferred method for commissuroplasty and skin closure for optimal functional and aesthetic results. The aim of this study is to present these techniques and the most described methods up to date.Further, five patients operated with a combination of techniques are presented. Material and methods PRISMA guidelines were followed for literature review.Five consecutive patients with unilateral macrostomia operated during a period of one and a half years at our craniofacial department were included in this study. Results 31 studies on macrostomia repair were obtained. The layered closure technique is widely described with several variations on closure of the inner mucosa, orbicularis muscle, commissure and skin. The inner mucosal layer is in most cases sutured with a straight line closure technique. The muscle is most often duplicated and sutured with upper branches overlapping lower branches. The skin is in most cases sutured with either a z- or a w-plasty with variations.The five presented patients all had satisfactory functional and aesthetic results at follow-up. Conclusion Many variations of surgical techniques for macrostomia repair have been presented in the past. We believe that each case of macrostomia needs to be assessed with a tailored surgical plan in order to create the best results. A combination of different techniques with Bütow and Botha's and Kaplan's technique as a starting point, is believed to give satisfactory functional and aesthetic results. © 2019 The Authors.Background In gender-confirming surgery of the female-to-male gender dysphoric patient, there is currently no ideal method for the creation of a neophallus. Historically, in our clinic, groin flap phalloplasty (GFP) has been the dominating method, but during the last 20 years, it has gradually been replaced with metoidioplasty (MP). The aim of this study was to investigate whether this change of method has influenced factors such as the frequency of complications and the number of operations needed to complete the reconstruction of the neophallus. Methods This is a retrospective, single-centre, study comprising 123 consecutive female-to-male patients receiving a neophallus by GFP or MP between 2002 and 2015 at Linköping University Hospital, Sweden. Results One-hundred twenty-three patients underwent 126 primary surgical procedures (39 GFPs and 87 MPs) with the intention of reconstructing a neophallus. The mean number of procedures required in the GFP group was 5.2 ± 2.7 compared with that of 2.4 ± 1.7 in the MP group (p less then 0.001). In the GFP group, 18/39 (46.2%) had a documented complication compared with 30/87 (34.5%) in the MP group; however, the difference was not statistically significant (p = 0.21). Conclusions The present study shows that the shift in method from GFP to MP has resulted in a decreased number of complications as well as a decrease in total surgical occasions. Both methods were found to be associated with relatively high frequencies of complications, however, mostly minor. © 2019 The Authors.Zoonotic infections represent an uncommon phenomenon. Few people with pets realise the infectious risk this entails. This case describes a Pasteurella canis infection of a breast implant following close contact between a patient and her cat. A 59-year-old woman developed infection of her breast implant 7 months after implantation. Surgical revision was performed after failure of conservative treatment with antibiotics. Perioperative samples from the periprosthetic fluid were positive for P. canis, a Gram-negative coccobacillus that is present in the oropharyngeal commensal flora of cats and dogs. History revealed that the patient owned a cat for 2 years. This case highlights the possible risk of zoonotic infections in humans with protheses following close contact with a cat. Antibiotic therapy and surgical revision, with or without removal of the prosthesis constitute the cornerstone of treatment in such cases. © 2019 The Authors.
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