Conservative Surgery of the Nasal Dorsum: Septal Pyramidal Adjustment and Repositioning

Facial Plastic Surgery ◽

10.1055/s-0041-1725102 ◽

2021 ◽

Author(s):

Wilson Dewes ◽

Carlos E.M. Zappelini ◽

Mario B.J. Ferraz ◽

Jose Carlos Neves

Keyword(s):

Nasal Septum ◽

Conservative Surgery ◽

Long Term Results ◽

Nasal Reconstruction ◽

Nasal Dorsum ◽

Late Sequelae ◽

Nasal Cartilage ◽

Modern Technique ◽

Push Down

AbstractThe term SPAR (septum pyramidal adjustment and repositioning), aims to conserve the nasal dorsum without detachment of the upper lateral nasal cartilage of the nasal septum, based on the Cotte's principles, unlike classical rhinoplasty. The aim of the study is to describe surgical technique of SPAR with the surgical steps used to reviewing the literature on the surgical treatment of the nasal dorsum. This is a less invasive form of rhinoplasty, but no less effective, not being necessary additional techniques to nasal reconstruction, and preservation of essential nasal structures. It is an evolution of push down and the other conservative surgery, making a more modern technique and may be suitable for most types of cavities. More studies are needed, especially comparative, showing the following late sequelae, complications, and their long-term results.

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Long-Term Results of Conservative Surgery and Radiotherapy for Ductal Carcinoma In Situ Using Lung Density Correction: The Unversity of Michigan Experience

Breast Diseases A Year Book Quarterly ◽

10.1016/s1043-321x(08)80119-1 ◽

2008 ◽

Vol 19 (2) ◽

pp. 175-176

Author(s):

S.M. MacDonald ◽

B.N. Napolitano

Keyword(s):

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Conservative Surgery ◽

Long Term Results ◽

Lung Density ◽

Density Correction

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Infiltrating ependymomas of the cauda equina

Journal of Neurosurgery ◽

10.3171/jns.1974.41.4.0446 ◽

1974 ◽

Vol 41 (4) ◽

pp. 446-448 ◽

Cited By ~ 25

Author(s):

Michael Scott

Keyword(s):

Cauda Equina ◽

Conservative Surgery ◽

Long Term Results ◽

Content Type ◽

Radical Removal ◽

Benign Course ◽

Fine Print

✓ The author reports the long-term results of combined conservative surgery and radiotherapy in the treatment of three patients with infiltrating papillary ependymomas Of the cauda equina. Seventeen to 20 years later they have relatively minimal complaints and dysfunction. This long benign course emphasizes the folly of attempting radical removal with its potential for serious mutilation of the cauda equina.

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Long-Term Results of Postoperative Hypofractionated Accelerated Breast and Lymph Node Radiotherapy (HypoAR) with Hypofractionated Boost

Current Oncology ◽

10.3390/curroncol28050300 ◽

2021 ◽

Vol 28 (5) ◽

pp. 3474-3487

Author(s):

Ioannis M. Koukourakis ◽

Marianthi Panteliadou ◽

Axiotis G. Giakzidis ◽

Christos Nanos ◽

Ioannis Abatzoglou ◽

...

Keyword(s):

Triple Negative ◽

Conservative Surgery ◽

Breast Conserving Surgery ◽

Long Term Results ◽

Radiation Dermatitis ◽

Radiation Toxicity ◽

Accelerated Radiotherapy ◽

Early Radiation ◽

Breast Quadrant

We report long-term results (median follow-up 12 years) of hypofractionated accelerated radiotherapy (HypoAR) in patients treated with breast-conserving surgery. In total, 367 women were treated with HypoAR. Axillary and supraclavicular area (ASA) were treated in patients with involved nodes. In total, 290 patients (scheme A) received 3.5 Gy/day ×10 fractions (breast/ASA) followed by two 4 Gy fractions with electrons to the affected breast quadrant within 16 days. In total, 77 patients (Scheme B) received 2.7 Gy/day for 16 consecutive fractions (breast/ASA) within 22 days, while concurrently, the affected breast quadrant received an electron booster dose of 0.8 Gy for the first 13 fractions. Amifostine was offered to 252/367 patients. Early radiation toxicity was minimal. Regarding late toxicities, symptomatic breast edema was noted in 2.2%, asymptomatic breast fibrosis in 1.9%, and arm lymphedema in 3.7% of patients. Amifostine reduced early radiation dermatitis (p = 0.001). In total, 2.2% of patients developed contralateral breast and 1.6% other carcinomas. Locoregional recurrence (LR) occurred in 3.1% of patients (0% for in situ carcinomas). Positive margins after surgery, extracapsular node invasion, and HER2-enriched/triple-negative tumors were linked with significantly worse LR-free survival. The involvement of more than three nodes and luminal type other than A were independent prognostic variables of metastasis and death events. HypoAR delivering a biological dose of 50–52 Gy to the breast/ASA is a safe and effective therapy for patients treated with conservative surgery. The risk of carcinogenesis is low. Positive surgical margins, extracapsular node invasion, and HER2-enriched/triple-negative phenotypes appear as a cluster of features linked with a higher risk for locoregional relapse.

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