Neurovascular Island Flap for Pulp and Nail Augmentation in Thumb Duplication Reconstruction: A Surgical Method With Long-Term Follow-Up

There are few long-term follow-up reports concerning the treatment of thumb duplication. We reviewed the treatment of 19 of 74 patients treated at our institution between 1956 and 2002. The average follow-up was 22 (range, 7 years to 35 years) years. Satisfactory function was achieved in 18 thumbs and cosmesis in 12 thumbs. Six thumbs were cold-intolerant at this late follow-up. Pinch strength was similar to the contralateral normal thumbs. Collateral ligament repair did not significantly contribute to joint stability. An objective method of postoperative evaluation showed good results in five, fair results in 12 and poor results in two thumbs.

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Preservation the Pulp Activity of the Involved Teeth in Jaw Cyst: an Observational Study

10.21203/rs.3.rs-197145/v1 ◽

2021 ◽

Author(s):

Gang Niu ◽

Qing-ling Li ◽

Yong-gang Tang ◽

Jing-jing Lv ◽

Li-song Lin ◽

...

Keyword(s):

Root Canal ◽

Common Disease ◽

Root Canal Therapy ◽

Surgical Method ◽

Jaw Cyst ◽

Vitality Test ◽

Long Term Follow Up ◽

Oral And Maxillofacial Region

Abstract Background: Jaw cyst is the most common disease of the oral and maxillofacial region. In addition to the pathogenic tooth, the roots of some teeth are often located in the cavity of the cystic capsule. Whether these involved teeth require root canal therapy and apicoectomy is still inconclusive. In the present study, we aimed to preserve the pulp activity of involved teeth in jaw cyst by improved operation.Methods: In our improved surgical method, the root canal therapy was not performed on the involved teeth, and no apical excision was performed during the operation. 63 involved teeth in 20 cases of jaw cyst treated by our department were selected between September 2015 and October 2017. The involved teeth were diagnosed by X-ray, CBCT, and a pulp vitality test before surgery. We observed the pulps' activity in the involved teeth and the efficacy of surgery for 12-36 months.Results: Electrical activity test of 63 involved teeth pulp in 20 patients with jaw cyst was normal or insensitively before operation. The involved teeth were preserved by improved surgical method. After 12-36 months’ follow-up, the pulp activity of 53 involved teeth (84.1%) were preserved, whereas 10 teeth (15.9%) showed adverse symptoms such as redness and swelling in the apical area, fistula, and pain. These symptoms resolved after postoperative root canal therapy. Chewing function was restored well. There was no recurrence and the bone cavity gradually reduced and finally disappeared, and bone density returned to normal after long term follow-up.Conclusion: Our results showed that to preserve the activity of the involved teeth for the treatment of jaw cyst by performing an improved operation method was effective.

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Complications of proximal hypospadias repair with transverse preputial island flap urethroplasty: a 15-year experience with long-term follow-up

Asian Journal of Andrology ◽

10.4103/aja.aja_115_18 ◽

2019 ◽

Vol 21 (3) ◽

pp. 300 ◽

Cited By ~ 2

Author(s):

Wei-Ping Zhang ◽

Hong-Cheng Song ◽

Chao-Xu Wang

Keyword(s):

Island Flap ◽

Hypospadias Repair ◽

Proximal Hypospadias ◽

Long Term Follow Up

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Recurrent Ventral Curvature with Long-Term Follow-up after Transverse Preputial Island Urethroplasty

European Journal of Pediatric Surgery ◽

10.1055/s-0039-1688479 ◽

2019 ◽

Vol 30 (05) ◽

pp. 429-433

Author(s):

Chaoxu Wang ◽

Hongcheng Song ◽

Weiping Zhang

Keyword(s):

Island Flap ◽

Surgical Reconstruction ◽

Long Term Outcomes ◽

Urethral Plate ◽

Urethral Strictures ◽

Primary Surgery ◽

Age At Surgery ◽

Long Term Follow Up

Abstract Objective This study was aimed to assess the long-term outcomes of recurrent ventral curvature (VC) repaired in early childhood after transverse preputial island flap urethroplasty. Materials and Methods A total of 378 patients underwent transverse preputial island flap urethroplasty between January 2000 and January 2005 at our hospital. Of these patients, 43 were invited for assessment of VC after puberty. The age at surgery, types of hypospadias, degrees of recurrent VC, and surgical procedures were analyzed. Results The study included 43 patients with a mean age of 15.9 years (range, 12.3–17.9). The average age at the time of primary surgery was 1.9 years (range, 1.2–3.6). Of 43 patients, recurrent VC was identified in 14 (32.5%). In total, 8 out of 16 patients (50.0%) were successfully treated by urethral plate transection with skin release during the primary surgery, and 6 out of 27 patients (28.6%) underwent additional dorsal plication (DP; p = 0.093). Severe recurrent VC was observed in four, moderate curvature was observed in four, and mild curvature was observed in six cases. Recurrent VC was present more often in patients with complications (34.6 vs. 24.1%, p = 0.331), especially in severe urethral strictures that required open surgical reconstruction (p = 0.039). Conclusion Although the patients in our study represent only a small portion of the overall hypospadias population, it is notable that 32.5% of these patients showed recurrent VC, including 28.6% of patients with transection plus DP. We suggest long-term follow-up of hypospadias at least during adolescence or even into adulthood.

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Improving the Penile Skin Adequacy and Appearance by Patching of the Preputial Skin Island Flap (PSIF) in Distal and Midshaft Hypospadias Associated with Severe Ventral Skin Deficiency: Experience in 224 Cases

Iranian Journal of Pediatrics ◽

10.5812/ijp.98051 ◽

2020 ◽

Vol 30 (3) ◽

Author(s):

Mansour Molaeian ◽

Farid Eskandari ◽

Hojattollah Raji ◽

Maryam Ghavami-Adel ◽

Arash Mollaeian

Keyword(s):

Island Flap ◽

Penile Skin ◽

Bare Area ◽

Skin Island ◽

Long Term Follow Up ◽

Distal Hypospadias ◽

Ventral Skin ◽

Skin Island Flap

Objectives: Reconstruction of ventral penile skin, in midshaft and distal hypospadias is problematic in many cases of severe ventral dysplasia. So we plan to use the tailored preputial skin island flap (PSIF) to cover the ventral defect. Methods: In this prospective cohort study 224 boys with midshaft and distal hypospadias associated with sever ventral dysplasia were operated from March 2009 until January 2016. The large U-shaped bare area which exposed on the ventrum after release of curvature was quilted by the PSIF as a patch. In each case, the variable size of the flap was required. The prepuces without the predominant artery were excluded from the study due to poor vasculature. The patients followed for 8 months to 7years. Results: Flap ischemia developed in 7 initial cases (3.125%), all of which subsequently faded. Some degree of ischemic discoloration was encountered at margins of the flap (12 cases, 5.3%), which resolved spontaneously. In 5 out of 224 patients (2.23 %), the flap persisted as a hypertrophied area of skin in the long-term follow-up. All of them needed to be corrected surgically. Near normal appearing penile skin was accomplished in the majority of patients during the follow-up. However, lack of the median raphe in the ventrum was evident in all. Conclusions: Tailored preputial skin island flap, as a native tissue to cover the exposed large bare area on the ventrum in cases of the distal and mid hypospadias with severe ventral dysplasia may improve the appearance and adequacy of the penile skin. It provides room for full erection and improves the patient’ s perception of body image and self-esteem.

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Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800105x ◽

2019 ◽

Vol 42 ◽

Cited By ~ 2

Author(s):

John P. A. Ioannidis

Keyword(s):

Mental Health ◽

Mental Disease ◽

Brain Disorders ◽

Social Stressors ◽

Labor Education ◽

Mental Diseases ◽

Long Term Follow Up ◽

Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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