scholarly journals Hyaluronic acid injections in post-enucleation or evisceration socket syndrome: a case series

2021 ◽  
Author(s):  
Renata Migliardi ◽  
Alessandra Modugno ◽  
Fabrizio Chirico ◽  
Nicola Zerbinati ◽  
Giovanni Francesco Nicoletti ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Case Series ◽  
Outpatient Setting ◽  
Level Of Evidence ◽  
Upper Eyelid ◽  
Filler Injection ◽  
Tear Trough Deformity ◽  
Vasovagal Response ◽  
Superior Sulcus ◽  
Therapeutic Study

Abstract Background One of the primary goals of enucleation and evisceration surgery is the restoration of an adequate orbital volume through the use of appropriately sized alloplastic or autogenous tissues. In patients inadequately treated, post-enucleation or evisceration socket syndrome occurs. Fillers are an ideal alternative for eyelid and eyebrow arcade volume enhancement since their injection is easily performed in an outpatient setting avoiding several complications. The aim of this study is to report the use of hyaluronic acid (HA) fillers to treat volume deficits of the upper and lower eyelids, projecting the brow arcade and reducing the asymmetry. Methods Thirteen patients (2 male, 11 female, mean age 32.7 years) were treated from June 2012 to May 2020. Non-surgical treatment by HA filler injection for aesthetic rehabilitation of deep superior sulcus, inferior tear trough deformity, and scleral show was performed. Results No complications as orbital-ache and/or vasovagal response were reported during the injections. Minor complications such as light swelling at the site of injection, self-resolved within 2 days, were recorded. Stable results were observed at follow-ups. In two cases, two successive treatments were required at 3 and 6 years from the first injection. Conclusions Hyaluronic acid fillers offer a versatile and safe method for replacing soft tissue lost from the upper eyelid/brow complex in cases of post-enucleation or evisceration socket syndrome. Level of evidence: Level IV, therapeutic study.

Late-Onset Upper Eyelid and Brow Edema as a Long-Term Complication of Hyaluronic Acid Filler Injection

2020 ◽  
Author(s):  
Biana Dubinsky-Pertzov ◽  
Francesco P Bernardini ◽  
Lior Or ◽  
Inbal Gazit ◽  
Morris E Hartstein
Keyword(s):  
Hyaluronic Acid ◽  
Late Onset ◽  
Level Of Evidence ◽  
Upper Eyelid ◽  
Noninvasive Treatment ◽  
Filler Injection ◽  
Eyelid Edema ◽  
Number Of Patients ◽  
Time Of Presentation

Abstract Background Late-onset upper eyelid edema is an uncommonly recognized complication of hyaluronic acid (HA)-based filler injection to the supraorbital area. Objectives The authors sought to report their experience in diagnosing and managing late-onset upper eyelid edema. Methods This was a noncomparative, retrospective study of a series of 17 consecutive patients who presented with upper eyelid edema 6 to 24 months after uneventful HA filler injection in the supraorbital area. Results The study group included 17 female patients. The average time of presentation was 13.9 months. Thirteen patients (76.4%) were satisfied after hyaluronidase and requested no further treatment (observation only); 4 patients (23.5%) elected to receive HA filler re-treatment, with satisfactory results. All patients were followed-up for at least 6 months after the re-treatment. Conclusions The incidence of late-onset upper eyelid edema is likely to increase as the number of patients undergoing HA filler injection to the supraorbital area increases. Our study emphasizes the importance of recognizing this condition and suggests a suitable noninvasive treatment with satisfying results for both the patient and the physician. Level of Evidence: 4

Premaxillary Injection for Perioral Rejuvenation and Lip Enhancement

2019 ◽  
Vol 40 (5) ◽  
pp. 560-567 ◽  
Author(s):  
Thuy-Van T Ho ◽  
Eric W Cerrati ◽  
Nimit D Gandhi ◽  
Arjun Kalbag ◽  
Steven H Dayan
Keyword(s):  
Hyaluronic Acid ◽  
Statistical Significance ◽  
Primary Objective ◽  
Upper Lip ◽  
Height Ratio ◽  
Level Of Evidence ◽  
Filler Injection ◽  
Nasal Tip ◽  
Tip Projection ◽  
Nasal Tip Projection

Abstract Background This is the first study to evaluate the effect of premaxillary filler injection on nasal tip projection, upper lip projection, and upper lip vermilion height. Objectives The primary objective of this study was to analyze the change in nasal tip projection (measured by the Goode ratio) and the change in upper lip projection (measured by the Z angle) following premaxillary hyaluronic acid injection. A secondary objective was to measure the change in upper lip vermilion height. We hypothesized that treated subjects will show an increase in nasal tip projection, upper lip projection, and upper lip vermilion height. Methods Twenty volunteer patients with signs of perioral aging or poor upper lip projection were enrolled in this prospective cohort study and underwent premaxillary hyaluronic acid filler injection between November 2017 and June 2018. Nasal tip projection, upper lip projection, and upper lip vermilion height were assessed from baseline and posttreatment photographs based on the Goode ratio, Z angle, and lip vermilion height ratio, respectively. Results No significant change was noted between pre- and posttreatment Goode ratio measurements (P = 0.841). There was a significant decrease in Z angle and therefore significant increase in upper lip projection with treatment (P < 0.001). The lip vermilion height ratio demonstrated a trend of increased upper lip vermilion height but this did not achieve statistical significance (P = 0.561). Conclusions Premaxillary filler treatment resulted in a significant increase in upper lip projection. Premaxillary filler injection when performed in a safe manner is a valuable treatment option for perioral rejuvenation. Level of Evidence: 4

scholarly journals Ultrasound-Guided Percutaneous Tenotomy for Gluteal Tendinopathy

2020 ◽  
Vol 8 (3) ◽  
pp. 232596712090786 ◽  
Author(s):  
Champ L. Baker ◽  
J. Ryan Mahoney
Keyword(s):  
Short Form ◽  
Tendon Repair ◽  
Case Series ◽  
Outpatient Setting ◽  
Harris Hip Score ◽  
Ultrasound Guided ◽  
Level Of Evidence ◽  
Nonsurgical Management ◽  
Gluteal Tendinopathy

Background: Gluteal tendinopathy is a common cause of lateral hip pain. Percutaneous ultrasonic tenotomy (PUT) has been used successfully for the treatment of tendinopathy of the elbow, knee, and ankle, but its use in the hip has not been described. Purpose: To evaluate the efficacy of PUT in patients who did not respond to nonsurgical management of gluteal tendinopathy. Study Design: Case series; Level of evidence, 4. Methods: A total of 29 patients with gluteal tendinopathy (mean age, 62 years) who did not respond to nonsurgical treatment were enrolled in this prospective study and underwent ultrasound-guided PUT in an outpatient setting. Patients with a history of ipsilateral hip surgery were excluded. All patients initially underwent magnetic resonance imaging or a computed tomography arthrogram demonstrating tendinopathy and/or partial tearing of the gluteus minimus or medius tendon or both tendons. Outcomes were assessed with a visual analog scale (VAS) for pain, the Harris Hip Score evaluation, and the 12-Item Short Form Health Survey (SF-12) before the procedure and at subsequent follow-up visits or by telephone interviews at 3 weeks, 3 months, 6 months, and final follow-up (range, 18-30 months). Results: The mean final follow-up was at 22 months postoperatively. At final follow-up, VAS scores had improved from a preprocedural mean ± SD of 5.86 ± 1.73 to 2.82 ± 2.22 ( P < .01). Harris Hip Scores improved from a preprocedural mean of 60.03 ± 10.86 to 77.47 ± 14.34 ( P < .01). Total SF-12 scores improved from a mean of 29.93 ± 5.39 (51% optimal) to 34.41 ± 4.88 (64% optimal) ( P < .01). No complications were reported. At final follow-up, when asked whether they would have the procedure again, 15 patients replied “yes definitely,” 3 replied “yes probably,” 3 replied “maybe,” 1 replied “likely not,” and 2 replied “definitely not.” There were 3 patients who eventually had hip abductor tendon repair, and their PUT procedures were considered failures. Conclusion: PUT is an effective treatment, with good results for patients with gluteal tendinopathy.

Ultrasound-Guided Hyaluronic Acid Injection for the Management of Morton’s Neuroma

2017 ◽  
Vol 39 (2) ◽  
pp. 201-204 ◽  
Author(s):  
Kang Lee ◽  
Il-Yeong Hwang ◽  
Chang Hyun Ryu ◽  
Jae Woo Lee ◽  
Seung Woo Kang
Keyword(s):  
Hyaluronic Acid ◽  
Case Series ◽  
Functional Improvement ◽  
X Rays ◽  
Ultrasound Guided ◽  
Morton’S Neuroma ◽  
Level Of Evidence ◽  
Hyaluronic Acid Injection ◽  
Acid Injection ◽  
Morton's Neuroma

Background: Morton’s neuroma is one of the common causes of forefoot pain. In the present study, hyaluronic acid injection was performed on patients to determine the efficacy and adverse effects of hyaluronic acid in management of Morton’s neuroma. Methods: Eighty-three patients with Morton’s neuroma in their third intermetatarsal space with definite Mulder’s click were included in the study. Those with severe forefoot deformities such as forefoot cavus or hallux valgus on plain X-rays were excluded. Ultrasound-guided hyaluronic acid injections were performed on all patients weekly for 3 weeks. Pain during walking using visual analogue scale (VAS) and AOFAS Forefoot Scale were prospectively evaluated preinjection, and at 2, 4, 6, 12 months postinjection. Results: Significant improvement in VAS and AOFAS Forefoot Scale were seen overall at 2 months after hyaluronic acid injections ( P < .05). Then, there were almost no changes after 4 months, continuing until 12 months. The mean VAS was decreased from 73.1 initially to 23.0 at 12 months and AOFAS Forefoot Scale was increased from 32.2 to 86.5. There were no complications which occurred. Conclusion: In the present study, ultrasound-guided hyaluronic injection was clinically effective for pain relief and functional improvement for at least 12 months in patients with Morton’s neuroma. However, numbness associated with Morton’s neuroma should be addressed more cautiously since it may persist without much improvement. Level of Evidence: Level IV, retrospective case series.

Metacarpal lengthening in children: comparison of three different techniques in 15 consecutive cases

2016 ◽  
Vol 42 (1) ◽  
pp. 51-56
Author(s):  
C. Dana ◽  
J.-C. Aurégan ◽  
A. Salon ◽  
S. Guéro ◽  
C. Glorion ◽  
...  
Keyword(s):  
Case Series ◽  
Single Stage ◽  
The Other ◽  
Extensor Mechanism ◽  
Two Stage ◽  
Level Of Evidence ◽  
Healing Index ◽  
Clinical Series ◽  
Therapeutic Study

Metacarpal lengthening is a useful procedure to address hand deficiencies in children. In this study, we aimed to compare the results of three different techniques from one consecutive clinical series of hand deficiencies. A total of 15 metacarpal lengthenings have been performed in 12 children aged from 9 to 14 years. The callotasis technique was used in seven cases, the two-stage distraction-graft technique in four cases and the single-stage lengthening in four cases. All the metacarpals healed with bone. The lengthening obtained was a mean of 13 mm (range 8–21 mm), a mean of 22 mm (range 13–32 mm) and a mean of 12 mm (range 9–15 mm), respectively, in the three different techniques. The healing index was longer for callotasis (81 days/cm) compared with the other techniques (41 days/cm and 46 days/cm, respectively). We observed one case of fracture after callotasis and one after distraction-graft. One patient underwent tenolysis of the extensor mechanism after single-stage lengthening. In conclusion, distraction graft and single-stage lengthening may be valuable alternatives to callotasis. Level of evidence: IV; therapeutic study; multi-case series

scholarly journals “Double-bundle” tibialis anterior tendon transfer for prevention of pes equinus after Chopart amputation

2020 ◽  
Vol 14 (1) ◽  
pp. 52-56
Author(s):  
Daniel Maricondi Massari ◽  
Marcio Gomes Figueiredo ◽  
Helencar Ignácio ◽  
Rafael Guirado ◽  
Wilisson Ribeiro Filho ◽  
...  
Keyword(s):  
Tibialis Anterior ◽  
Tibialis Anterior Muscle ◽  
Case Series ◽  
Double Bundle ◽  
Level Of Evidence ◽  
Tibialis Anterior Tendon ◽  
Therapeutic Study ◽  
Midtarsal Joint ◽  
Patient Performance

Objective: Assess patient performance and quality of the stump after amputation at the Chopart (midtarsal) joint, with double-bundle transfer of the tibialis anterior muscle tendon to the talar neck. Methods: This study evaluated the medical records of 5 patients who underwent Chopart amputation with double-bundle transfer of the tibialis anterior tendon to the talar neck, assessing pre and postoperative performance and gait. Results: The patients were operated on between January 2008 and December 2018, and the data obtained from the survey allow us to conclude that, after the proposed procedure, all patients reported an improvement in walking, besides noting a significant reduction in the degree of stump equinus. Conclusion: The surgical technique described in this article produced a significant improvement in patient performance as assessed by the AOFAS hindfoot score, and prevented the formation of ulcers in the anterior region of the stump. Level of Evidence IV; Therapeutic Study; Case Series.

scholarly journals The L-shaped modification of the transverse upper gracilis (TUG) flap

2020 ◽  
Vol 43 (6) ◽  
pp. 837-842
Author(s):  
Juan Enrique Berner ◽  
John M. D. Henton ◽  
Adam Blackburn
Keyword(s):  
Donor Site ◽  
Case Series ◽  
Diep Flap ◽  
Level Of Evidence ◽  
Skin Paddle ◽  
Medial Thigh ◽  
First Choice ◽  
Prospective Case Series ◽  
Tissue Flaps ◽  
Therapeutic Study

AbstractA variety of free tissue flaps have been described for autologous breast reconstruction. Although the deep inferior epigastric perforator (DIEP) flap is most microsurgeons’ first choice, there is no consensus regarding which is the second-best alternative. The transverse upper gracilis (TUG) flap has gained popularity for cases where the abdomen is not a suitable donor site. This musculocutaneous flap has the advantage of an easy dissection, allowing the harvest of tissue from the medial thigh area with the patient supine. However, drawbacks include a tedious donor site closure and a limited amount of soft tissue that can be transferred. The authors hereby present a modification of the TUG flap, introducing an L-shaped skin paddle: the L-shaped upper gracilis (LUG) flap. This alternative allows harvesting extra tissue from the medial thigh, while providing an easier donor site closure with the patient supine. A prospective case series of 14 LUG flaps is presented. No flap failures or episodes of fat necrosis were encountered; only one developed a donor site seroma that settled after drainage. The LUG flap is a useful development of the TUG flap concept providing up to 50% more tissue than a standard TUG flap with an aesthetically pleasing donor site closure which is useful for cases in which abdominal flaps are not possible.Level of evidence: Level IV, therapeutic study.

Safe Glabellar Wrinkle Correction With Soft Tissue Filler Using Doppler Ultrasound

2020 ◽  
Author(s):  
Won Lee ◽  
Hyoung-Jin Moon ◽  
Ji-Soo Kim ◽  
Eun-Jung Yang
Keyword(s):  
Hyaluronic Acid ◽  
Botulinum Toxin ◽  
Soft Tissue ◽  
Doppler Ultrasound ◽  
Vascular Complications ◽  
Level Of Evidence ◽  
Filler Injection ◽  
Subcutaneous Layer ◽  
Soft Tissue Filler

Abstract Background Glabellar wrinkle corrections are usually performed by injecting botulinum toxin and hyaluronic acid fillers. The glabella is one of the most dangerous locations for filler injection because of possible visual complications. Objectives The aim of this study was to use Doppler ultrasound to determine the anatomic relation between glabellar wrinkles and the supratrochlear artery pathway, perform safe hyaluronic acid filler injection to correct glabellar wrinkles, and determine the efficacy of the procedure. Methods From January 2019 to July 2019, 42 patients (74 glabellar wrinkle lines; 32 bilateral and 10 unilateral wrinkles) were evaluated. Glabellar wrinkle lines were corrected with hyaluronic acid filler. Doppler ultrasound was used to avoid the supratrochlear artery. Results Among the 74 wrinkle lines, the supratrochlear arteries were located either at the glabellar wrinkle lines (30/74, 41%) or lateral to the glabellar wrinkle lines (44/74, 59%). In the latter 44 wrinkles, fillers were injected into the subdermal layer of the glabellar wrinkle lines. In the 30 wrinkles where supratrochlear artery was located at the glabellar wrinkle lines, the artery was located at the deep subcutaneous layer in 24 and at the subdermal layer in 6; thus, filler injection was not performed. Conclusions The supratrochlear artery may be located either at or lateral to the glabellar wrinkle lines. When performing glabellar wrinkle correction, Doppler ultrasound can be used to confirm the location of the supratrochlear artery before filler injection, which helps in avoiding vascular complications. Level of Evidence: 4

scholarly journals Clinical Efficacy and Safety of Non-Cross-Linked Hyaluronic Acid Combined with L-carnosine for Horizontal Neck Wrinkles Treatment

2021 ◽  
Author(s):  
Shiwei Wang ◽  
Huanyun Niu ◽  
Yao Liu ◽  
Yawen Tan ◽  
He Gao ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Adverse Events ◽  
Treatment Plan ◽  
Treatment Options ◽  
Critical Role ◽  
Full Description ◽  
Efficacy And Safety ◽  
Level Of Evidence ◽  
Filler Injection ◽  
Based Medicine

AbstractBackground Horizontal neck wrinkle formation is gaining more attention among cosmetic practitioners and clients. To date, hyaluronic acid products are one of the most common treatment options for this aesthetic concern. However, different therapeutic strategies should be given to solve the problem due to multiple etiological reasons. Given that oxidative damage plays a critical role in neck wrinkle formation, anti-oxidative compounds are now considered by physicians when making a treatment plan. Aims To evaluate the efficacy and safety of a non-cross-linked hyaluronic acid filler in combination with L-carnosine in treating horizontal neck wrinkles. Methods Thirteen patients with a Wrinkle Assessment Scale (WAS) of 2–5 for horizontal neck wrinkles were treated with L-carnosine-containing non-cross-linked hyaluronic acid. Participants were followed-up for 3 months after treatment. The post-treated WAS scores evaluated by physicians were collected when patient satisfaction was surveyed. Any post-treatment adverse events were recorded. Results With a single injection of the above filler, the physician-evaluated WAS scores improved by at least one score at one month and the improvement kept consistent as far as three months after injection. According to the last follow-up visit, 11/13 patients were satisfied with the treatment effect of their neck wrinkle. Moreover, adverse events were rare after filler injection, except for local complications that were considered common reactions to the filler injection procedure. Conclusion The non-cross-linked hyaluronic acid filler containing L-carnosine is safe and effective for treating horizontal neck wrinkles.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

scholarly journals Insertional Achilles tendinopathy

2020 ◽  
Vol 14 (1) ◽  
pp. 68-73
Author(s):  
Lucas Candido Honório ◽  
Mariana Alcantara Roldi de Azeredo ◽  
Joaquim Maluf Neto
Keyword(s):  
Functional Performance ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Calcaneal Tendon ◽  
Functional Quality ◽  
Case Series Study ◽  
Therapeutic Study ◽  
The Impact

Objective: Retrospectively analyze surgical procedures performed on patients with insertional Achilles (calcaneal tendon) tendinopathy, focusing on outcomes and the impact on the patients’ functional quality. Methods: A descriptive, retrospective, case series study drawn up by collecting data directly from the patients’ medical records. For the functional analysis of patients, we used the questionnaire of the adapted American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS). An assessment was carried out on each of the patients who underwent surgery at our hospital from 2010 to 2019, using the surgical technique described in this article, i.e., resection of the affected portion of the tendon with its subsequent reinsertion. Results: All surgical patients achieved an improvement in their AOFAS score and in pain levels, with good functional performance only three months into the postoperative period, from 50.1 to 83.75 (p<0.001). Conclusion: The use of the technique proved very effective, particularly in terms of the maintenance of foot function and important improvement in pain levels, thus producing a relevant increase in function among patients. Level of Evidence IV; Therapeutic Study; Case Series.

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