Auricular composite grafting to repair nasal vestibular stenosis

Nasal vestibular stenosis is defined as a narrowing of the nasal inlet resulting in airway obstruction. Causes include nasal trauma, infection, and iatrogenic insults. The objectives of this article are to illustrate nasal vestibular stenosis and to analyze common causes and surgical treatments. The operative technique of the senior author (M.S.K.), will be presented. Donor site morbidity and patient outcomes will be discussed. Sixteen patients were seen during a 5-year period. Eleven women and 5 men were evaluated and found to have nasal vestibular stenosis. Three patients had stenosis as a result of nasal fracture or laceration. Stenosis developed in the remaining 13 as a result of nasal surgery. All patients underwent auricular composite grafting, and grafts took in 100%. Partial skin slough occurred in up to 50%; however, re-epithelialization was seen within 3 weeks. Complications were seen at the donor site. Immediate patient satisfaction was seen and continues during long-term follow-up.

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Case Report

Hand ◽

10.1177/1558944716658748 ◽

2016 ◽

Vol 11 (4) ◽

pp. NP38-NP40 ◽

Cited By ~ 1

Author(s):

Sanjay Naran ◽

Joseph E. Imbriglia

Keyword(s):

Case Report ◽

Donor Site ◽

Donor Site Morbidity ◽

No Donor ◽

Metacarpophalangeal Joints ◽

Active Function ◽

Patient Reported ◽

Long Term Follow Up

Background: A case is discussed in which a young girl was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits at the age of four. At 39 years of age, she presented incidentally to our clinic and was observed to have a very functional hand with mobile metacarpophalangeal joints in all reconstructed digits. Methods: We present a case report which is discussed in the context of long-term follow-up, and phalangeal growth in the absence of distraction, and a review of the current literature in regards to outcomes for this modality of treatment. Results: We document growth of the transplanted phalanges, despite surgery occurring after the reported optimum age of before 18 months, and the patient not undergoing distraction. The patient reported no donor site morbidity in regards to function or psychosocial impact. Furthermore, we observed active function at the metacarpophalangeal joints of all operated digits. Conclusions: We report the longest follow-up (35 years) following nonvascularized proximal toe phalangeal transfer for short finger type symbrachydactyly. We highlight the long-term functional outcome of nonvascularized toe phalangeal transfers, and present an overview of the current outcome literature for this type of procedure, advocating that nonvascularized toe phalangeal transfers remain a viable treatment option for select cases of symbrachydactyly.

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Long-term follow-up of donor site morbidity after defect coverage with Integra following radial forearm flap elevation

European Journal of Plastic Surgery ◽

10.1007/s00238-013-0918-0 ◽

2014 ◽

Vol 37 (3) ◽

pp. 159-166 ◽

Cited By ~ 15

Author(s):

Anna Wirthmann ◽

Juliane C. Finke ◽

Pietro Giovanoli ◽

Nicole Lindenblatt

Keyword(s):

Donor Site ◽

Donor Site Morbidity ◽

Radial Forearm Flap ◽

Defect Coverage ◽

Forearm Flap ◽

Long Term Follow Up ◽

Radial Forearm ◽

Flap Elevation

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Recurrent metastatic primary inflammatory myofibroblast tumour of the gallbladder following pancreaticoduodenectomy

BMJ Case Reports ◽

10.1136/bcr-2019-232861 ◽

2020 ◽

Vol 13 (2) ◽

pp. e232861

Author(s):

Roi Anteby ◽

Brianne J Sullivan ◽

Malary Mani ◽

Benjamin Golas

Keyword(s):

Distant Metastases ◽

R0 Resection ◽

Soft Tissue Tumour ◽

En Bloc ◽

Tissue Tumour ◽

Common Causes ◽

Long Term Follow Up ◽

Surgical Treatments

Inflammatory myofibroblast tumour (IMT) is an uncommon soft tissue tumour with an unpredictable clinical course: mostly benign, occasionally locally aggressive and rarely capable of metastasis. Diagnosed mainly in the mesentery, omentum, retroperitoneum, pelvis and lungs, IMT is extremely rare as a primary gallbladder tumour. Despite improved radiographical capabilities, differentiating the tumour from other more common causes of gallbladder neoplasms necessitates histopathological and immunohistochemistry tests. Once diagnosed, malignant potential should be taken into consideration, striving for an en bloc R0 resection and postoperative long-term follow-up with routine ancillary imaging. The authors present the case of a recurrent primary IMT of the gallbladder, after two surgical treatments, including a pancreaticoduodenectomy. Now 3 years after initial diagnoses the patient is asymptomatic, but has developed local and distant metastases and is being treated with systemic corticosteroid.

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Nipple Reconstruction Techniques: Which is the Best Choice?

Open Medicine Journal ◽

10.2174/1874220301805010062 ◽

2018 ◽

Vol 5 (1) ◽

pp. 62-75 ◽

Cited By ~ 1

Author(s):

Nicolò Bertozzi ◽

Francesco Simonacci ◽

Marianna Pesce ◽

PierLuigi Santi ◽

Edoardo Raposio

Keyword(s):

Donor Site ◽

Donor Site Morbidity ◽

Contralateral Side ◽

Skin Thickness ◽

Nipple Reconstruction ◽

Areolar Complex ◽

Long Term Follow Up ◽

Case Basis

Nipple-Areolar Complex (NAC) reconstruction represents the final, concluding journey of breast reconstruction by being able to give to reconstructed breasts the shape of a natural breast mound. Nevertheless an enormous amount of nipple reconstruction techniques are described in literature, given the fact that most reconstructive options fail to give satisfactory outcomes in relation to the long-term nipple projection. In this review, the authors will browse most common nipple reconstruction techniques, taking into account: Indication, outcome, and side effect. Composite nipple grafts, traditional flaps, flaps with autologous graft augmentation, flaps with allograft augmentation, and flaps with alloplastic augmentation are the main strategies employed nowadays. Composite nipple grafts give the best guarantee of color-texture match with the contralateral side and show satisfactory nipple projection even at long-term follow-up. Skate, star, C-V, and arrow flap are by far the most commonly employed and the most reliable local flaps, however loss of projection of up to 70 percent are reported in literature. Alloplastic grafts were associated with the lowest rates of projection loss followed by autologous and allogenic ones. Nevertheless allogenic grafts are also associated with the highest complication rate, while autologous and allogenic ones have similar rates. Infection, seroma, and fat necrosis are the more commonly reported complications of autologous grafting along with donor site morbidity, while allogenic and alloplastic augmentation grafts may also experience the risk of overcorrection and graft exposure. Given the numerous techniques described in literature it is clear that the ideal nipple reconstruction hasn’t been found yet. Whereas it should be chosen on case to case basis depending on type of mastectomy, radiotherapy, type of reconstruction, skin thickness, tissue condition, and patients’ expectations to ensure the best cosmetic outcome.

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Long Term Follow-Up of Composite Non-Vascularized Toe Phalanx Transfers for Aphalangia

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2005.06.001 ◽

2005 ◽

Vol 30 (5) ◽

pp. 452-458 ◽

Cited By ~ 18

Author(s):

M. A. TONKIN ◽

A. K. DEVA ◽

S. L. FILAN

Keyword(s):

Soft Tissue ◽

Donor Site ◽

Proximal Phalanx ◽

Donor Site Morbidity ◽

Joint Motion ◽

Active Joint ◽

Long Term Follow Up

The results of 21 non-vascularized toe phalanx transfers in 13 patients were reviewed radiologically with respect to function, physeal patency, growth and donor site morbidity at a mean follow-up of 7.4 (range 2.9–13.6) years. Physeal patency was maintained in 4 of 18 surviving transfers. The length of the transferred phalanx averaged 75% of the contralateral comparable toe phalanx and 44% of the contralateral digit proximal phalanx. Most patients had good or simple use of the hand with active joint motion. There was universal shortening of the donor toe with hypoplasia of the middle and distal phalanges. This review suggests that transfer of a non-vascularized toe phalanx provides a reliable but limited means for increasing length of a digit, stabilizing soft tissue “nubbins” and improving function. Longer follow-up has shown more modest gains in growth than in some previous reports.

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Mid-term Outcome Of Surgical Treatment In Pediatric Patients With Ebstein's Anomaly: A Single-center Cohort Study.

10.21203/rs.3.rs-42297/v1 ◽

2020 ◽

Author(s):

Jia-chen Li ◽

Xian-chao Jiang ◽

Si-meng Zhang ◽

Jin-yang Liu ◽

Ya-juan Zhang ◽

...

Keyword(s):

Surgical Treatment ◽

Reoperation Rate ◽

Term Effect ◽

Ebstein’S Anomaly ◽

Biventricular Repair ◽

Ebstein's Anomaly ◽

Long Term Follow Up ◽

Surgical Treatments

Abstract Background: Ebstein’s anomaly is a malformation of the tricuspid valve and myopathy of the right ventricle. Surgery is now the main treatment for the defect. To summarize our surgical results and experience based on patients with Ebstein’s anomaly who were under 7 years of age and treated with different surgical treatments.Materials and Methods: From January 2010 to December 2019, 80 patients under 7 years old who were diagnosed of Ebstein’s anomaly and underwent different surgical treatments were consecutively enrolled and followed up in detail. Results: The median age of the 80 patients at the time of surgery was 3.63 years. Sixty-four (80.00%) patients underwent biventricular repair while 13 (16.25%) underwent 1.5-ventricle repair. With the median follow-up 27.50 months, the long-term survival of the total cohort, 1.5-ventricular repair and biventricular repair was 82.35%, 91.67% and 100%, respectively. The long-term freedom from reoperation rate was 97.50%, 92.31% and 98.44%, respectively. Mild, moderate and severe TR before surgery occurred in 6 (7.50%), 18 (22.50%) and 56 (70.00%), respectively. The early outcomes of 78 patients were 65 (83.33%), 11 (14.11%) and 2 (2.56%); the mid-term outcomes of 72 patients were 49 (68.06%), 19 (26.38%) and 4 (5.56%). Both early and long-term valve regurgitation were significantly decreased (p< 0.001) compared with preoperative condition. No more severe regurgitation occurred (p=0.404), though some early mild regurgitation became acceptable moderate regurgitation during long-term follow-up (p=0.036). Compared with Carpentier procedure, cone procedure had better long-term effect, while the effect of whole-valve technique needed more operation and long-term follow-up.Conclusion: The reoperation rate and mid-term mortality of surgical treatment for Ebstein’s anomaly were both low, tricuspid regurgitation was significantly improved during mid-term follow up. Cone procedure had the best mid-term effect among anatomic repair.

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Long-Term Results of Autologous Auricular Cartilage Graft Applied in Anophthalmic Orbits Unable to Wear Prosthesis

Journal of Ophthalmology ◽

10.1155/2019/7197063 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Yi-Lin Liao ◽

Shu-Ya Wu ◽

Yueh-Ju Tsai

Keyword(s):

Donor Site ◽

Donor Site Morbidity ◽

Long Term Results ◽

Chang Gung Memorial Hospital ◽

Cartilage Graft ◽

Auricular Cartilage ◽

Prosthesis Fitting ◽

Prosthesis Retention

In anophthalmic patients, shallow lower fornices make wearing ocular prostheses impossible and maintaining normal social activities difficult. This study retrospectively investigated the long-term surgical outcomes of autologous auricular cartilage grafting for contracted orbits. From 1995 to 2013, 29 anophthalmic contracture sockets with inadequate lower fornices and poor prosthesis retention presented to Chang Gung Memorial Hospital in Linkou, Taiwan, were treated using this surgical method. The success rate, aesthetic outcome, recurrence, and complications were analyzed. Among the 29 patients, 15 were women, 14 were men, their mean age was 45 years, and the mean follow-up time was 52 months (range = 6–159 months). Satisfactory lid position was achieved in 25 cases (86%), and lower fornix retraction recurred in four cases (14%). Neither donor site morbidity nor auricular deformity was noted during the follow-up period. Therefore, an auricular cartilage graft can be used successfully as a compatible spacer for anophthalmic patients with shallow lower fornices and prosthesis-fitting problems in long-term follow-up.

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Hydroxyapatite-Coated Femoral Stem Survivorship at 10 Years

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.284-286.1069 ◽

2005 ◽

Vol 284-286 ◽

pp. 1069-0 ◽

Cited By ~ 2

Author(s):

Gregory Y. Lee ◽

Ajay Srivastava ◽

Darryl D. D'Lima ◽

Pam Pulido ◽

Clifford W. Colwell

Keyword(s):

Polyethylene Wear ◽

Femoral Stem ◽

Senior Author ◽

Independent Observer ◽

Long Term Follow Up ◽

The Mean ◽

Lost To Follow Up ◽

Hip Arthroplasties

The Omnifit-HA femoral stem component has shown excellent results in early clinical studies. This is an independent prospective study of the outcome of a ydroxyapatite-coated femoral component implanted by one surgeon with an intermediate-term follow up. The senior author performed 103 consecutive uncemented total hip arthroplasties in 96 patients from July 1991 to December 1996. The components implanted were the Omnifit-HA femoral stem and the Omnifit PSL porous-coated acetabular shell. The mean age at the time of the index procedure was 52 years old (range, 27–78) and male:female ratio was 54:42. Three patients were deceased and four patients were lost to follow-up. The mean follow up was 10.3 years (range, 7.3–12.7 years). Clinical and radiographic evaluations were performed by an independent observer. The average preoperative and postoperative Harris Hip Scores were 55 and 92, respectively. The overall survivorship of the Omnifit-HA stem was 100% with no femoral revisions. The survivorship of the Omnifit PSL cup was 89.7% with 4 acetabular revisions for aseptic loosening and 6 polyethelene liner exchanges for osteolysis or late instability. The mean polyethylene wear rate was 0.24 mm per year. This long-term follow up shows that the use of circumferentially coated hydroxyapatite stems can protect against the migration of wear debris along the femoral stem.

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