scholarly journals 57 The Use of a Hemi Glabella Flap for Reconstruction of Medial Canthus Defects

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
P Tan ◽  
J Agilinko ◽  
A Khalil
Keyword(s):  
Donor Site ◽  
Advancement Flap ◽  
Senior Author ◽  
Lateral Nasal Wall ◽  
Oral Antibiotics ◽  
Aesthetic Outcome ◽  
Medial Canthus ◽  
Complex Anatomy ◽  
The Aesthetic

Abstract Background Medial canthal reconstruction is a challenging task due to the complex anatomy. The glabellar flap is a common viable technique; however, this results in narrowing of the eyebrows, bulky nasal dorsum and horizontal scarring which is aesthetically displeasing. The senior author in this paper has developed an intuitive modification to the technique. Method A rotational advancement flap involving the upper lateral nasal wall with the hemi glabella was formed and transferred to the medial canthal defect. The donor site was closed in a V-Y manner. Complete closure of defect was achieved in all patients. Results Reconstruction using the Hemi-Glabellar technique was performed on 12 patients following resection of BCC in or near the medial canthus area. Superficial cellulitis was noted in 2 patients, they were managed oral antibiotics. There was bruising in 7 patient which resolve spontaneously in 4-7 days. All patients had a good outcome at 2 months and 6 months follow up. There was no flap loss and all patients were satisfied with the aesthetic outcome. Conclusions The technique highlighted can be performed easily and is applicable to reconstruction to defects of the medial canthus with excellent aesthetic outcomes with an inconspicuous scar and supple skin with matching colour

scholarly journals Long-term evaluation of autologous lamellar corneal grafts for the treatment of deep corneal ulcer in four dogs: a case report

2019 ◽  
Vol 64 (No. 02) ◽  
pp. 84-91
Author(s):  
SY Kim ◽  
JY Kim ◽  
SW Jeong
Keyword(s):  
Case Report ◽  
Corneal Ulcer ◽  
Donor Site ◽  
Ultrasound Biomicroscopy ◽  
Corneal Graft ◽  
Corneal Ulcers ◽  
Term Evaluation ◽  
The Aesthetic

Autologous lamellar corneal grafts were performed on four dogs with two deep corneal ulcers and two corneal perforations to achieve better visual and aesthetic outcomes. The donor corneal graft was harvested from the relatively normal corneal region of the affected eye and used to cover the corneal defect. At the two-year follow-up examination, ultrasound biomicroscopy was performed to confirm the thickness and endothelial continuity of the transplanted grafts and donor site of the cornea. The evaluations revealed that the dogs had healed without incident and that their vision had been maintained. Furthermore, the owners were satisfied with the aesthetic outcomes in all cases. Our findings show that autologous lamellar corneal grafts are useful and effective in treating canine corneal ulcers and perforations.

scholarly journals Functional and aesthetic outcomes of first dorsal metacarpal artery flap for thumb reconstruction: a prospective study

2020 ◽  
Vol 7 (7) ◽  
pp. 2268
Author(s):  
Sujana Ravada ◽  
Surya Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand Prasath Jayachandiran
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Sensory Function ◽  
Soft Tissue Defects ◽  
Aesthetic Outcome ◽  
Dorsal Metacarpal Artery ◽  
The Mean ◽  
The Aesthetic ◽  
Tissue Defects ◽  
First Dorsal Metacarpal Artery

Background: Reconstruction of soft tissue defects of the thumb, with exposure of tendon, joint or bone, has been a challenging problem. Surgical options include local, regional or free flaps. Here, we have evaluated the functional and aesthetic outcomes of first dorsal metacarpal artery (FDMA) island flap in reconstruction of various soft tissue defects of the thumb.Methods: Between January 2018 and January 2019, twenty patients with post-traumatic and post-infective thumb defects underwent FDMA flaps. Sensory function was evaluated with static 2 point discrimination and mobility of the thumb was tested by the Kapandji score. The aesthetic outcome was also assessed.Results: The mean defect size was 39.9×19.95 mm. Eighteen flaps survived completely and one had distal flap necrosis and one had superficial epidermal peeling which was treated conservatively. The mean static two-point discrimination was 9.3 mm. Cortical reorientation was complete in 45%. The average Kapandji score was 7.9. The aesthetic outcome was excellent in ten, good in eight and poor in two subjects. After a mean follow up period of 11.85 months, most patients regained all functions of the thumb and index finger and were pleased with the cosmetic appearance of the flap and donor site.Conclusions: FDMA flap offers a good quality skin cover for small to moderate sized thumb defects. It is a reliable and versatile flap which is sensate and pliable. It gives excellent functional and aesthetic outcomes with minimal or no donor site morbidity.

scholarly journals Coverage of defects over toes with distally based local flaps: A report of four cases

2008 ◽  
Vol 41 (01) ◽  
pp. 62-66
Author(s):  
Ashok Raj Koul ◽  
Rahul K. Patil ◽  
Vinoth Kumar Philip
Keyword(s):  
Donor Site ◽  
Advancement Flap ◽  
Skin Flaps ◽  
Challenging Problem ◽  
Success Rates ◽  
Muscle Flaps ◽  
Variable Success ◽  
Distally Based ◽  
Extensor Digitorum Brevis

ABSTRACTreconstruction of the distal foot, especially of the toe has always been a challenging problem. various methods have been tried with variable success rates and limitations. presented here is a series of four cases, where distally based flaps were used. two of them were extensor digitorum brevis (edb) muscle flaps and the other two were first dorsal metatarsal artery (fdma) based skin flaps. one in each of the two was augmented with a plantar v-y advancement flap. all flaps survived completely without any flap- or donor site-related complications. the patients were ambulated two weeks following the reconstruction and were symptom-free after an average follow-up of thirteen months. distal flaps based on the dorsalis pedis system provide a reliable cover for distal foot defects.

scholarly journals Use of amniotic membrane for radial forearm free flap donor site coverage: clinical, functional and cosmetic outcomes

2019 ◽  
Vol 24 (7) ◽  
pp. 2433-2443 ◽  
Author(s):  
Stefan Hunger ◽  
Lukas Postl ◽  
Raphael Stehrer ◽  
Lukas Hingsammer ◽  
Stefan Krennmair ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Grip Strength ◽  
Free Flap ◽  
Amniotic Membrane ◽  
Donor Site ◽  
Subjective Rating ◽  
Radial Forearm Free Flap ◽  
Aesthetic Outcome ◽  
Radial Forearm ◽  
The Aesthetic

Abstract Objective To evaluate the clinical, functional and aesthetic outcomes for radial forearm free flap (RFFF) donor sites covered with amniotic membrane (AM). Material and methods The healing process of patients with RFFF donor sites covered with AM was prospectively followed for 1 year. Additionally at the 12-month evaluation, objective scoring systems were used to assess the aesthetic (Vancouver scar scale, VSS: range 1–13) and functional outcome (skin sensibility, hand/wrist functionality [goniometer], grip strength [score 1 = excellent, 5 = poor]). By using a subjective rating system (score 1 = excellent, 5 = poor), the patient-reported aesthetic and functionality outcome was correlated with objective data analysis. Results Twenty-one out of 23 patients were followed for 12 months (dropout: 2 patients at 3 months). In 17/23 (73.9%) patients RFFF defect covered with AM showed an uneventful healing period (< 3 months). Prolonged healing periods (> 3 months < 6) for 6 patients (26.1%) were attributed to wound infections (4×), seroma (1×) and inflammation (1×). At the 1-year evaluation, there was a significant (p < 0.01) correlation between subjective (2.0 ± 0.71) and objective aesthetic scores (VVS 3.74 ± 2.18), and a successful grip strength (score 1.67 ± 0.86); however, thumb hyposensibility in 76.2% was seen. A high body mass index (BMI) was in conjunction with a negative (p = 0.012) and the use of antihypertensive medications provided positive effects (p = 0.041) on the aesthetic outcome. Conclusion RFFF donor site defects covered using AM show excellent clinical, aesthetic and functional outcome representing patient comorbidities (BMI, antihypertensive drugs) might affect the aesthetic outcome. Clinical relevance In relation to the excellent outcomes found, the use of AM offers an alternative treatment procedure for RFFF defect covering.

scholarly journals Microneurosurgical Management of Posterior Inferior Cerebellar Artery Aneurysms: Results of a Consecutive Series

2021 ◽  
pp. 33-38
Author(s):  
Mattia Del Maestro ◽  
Sabino Luzzi ◽  
Renato Galzio
Keyword(s):  
Posterior Inferior Cerebellar Artery ◽  
Cranial Nerves ◽  
Lateral Approach ◽  
Senior Author ◽  
Preoperative Imaging ◽  
Imaging Evaluation ◽  
Complex Anatomy ◽  
Cerebellar Artery ◽  
Pica Aneurysms

AbstractAneurysms of the posterior inferior cerebellar artery (PICA) are uncommon. The complex anatomy of PICA and its intimate relationships with medulla, lower cranial nerves, and jugular tubercle makes the surgical treatment of these aneurysms fascinating. The reported is study aimed at a critical review of the overall results of a personal series of PICA aneurysms, treated by the senior author, R. Galzio. Demographics, charts, videos, outcome, and follow-up of a cohort of PICA aneurysms managed in the last 10 years were retrospectively analyzed, focusing only upon those treated with microneurosurgery. Twenty-five patients, harboring a single aneurysm, were operated on. Fifteen aneurysms were ruptured. Nineteen were proximal, all of these being been treated through a far-lateral approach. Trans-condylar or trans-tubercular variants were rarely necessary and however reserved to peculiar cases. Twenty-three aneurysms underwent direct treatment consisting of clip ligation. At 6-month follow-up, 60% of patients had a modified Rankin Score (mRS) of 0–2. Given the high anatomical variability of both PICA and patients’ bony anatomy, a case-by-case meticulous preoperative imaging evaluation is mandatory for the choice of the most suitable and tailored surgical corridor which, in turn, is pivotal to achieve the best outcome.

Reconstruction of unicoronal plagiocephaly with a hypercorrection surgical technique

2011 ◽  
Vol 31 (2) ◽  
pp. E4 ◽  
Author(s):  
John M. Mesa ◽  
Frank Fang ◽  
Karin M. Muraszko ◽  
Steven R. Buchman
Keyword(s):  
Surgical Technique ◽  
Surgical Repair ◽  
Surgical Techniques ◽  
Senior Author ◽  
Surgical Correction ◽  
Surgical Reconstruction ◽  
Calvarial Bone ◽  
The Mean ◽  
The Aesthetic

Object Successful surgical repair of unicoronal plagiocephaly remains a challenge for craniofacial surgeons. Many of the surgical techniques directed at correcting the stigmata associated with this craniofacial deformity (for example, ipsilateral supraorbital rim elevation [vertical dystopia], ipsilateral temporal constriction, C-shaped deformity of the face, and so on) are not long lasting and often result in deficient correction and the need for secondary revision surgery. The authors posit that the cause of this relapse was intrinsic deficiencies of the current surgical techniques. The aim of this study was to determine if correction of unilateral coronal plagiocephaly with a novel hypercorrection surgical technique could prevent the relapse of the characteristics associated with unicoronal plagiocephaly. Methods The authors performed a retrospective analysis of 40 consecutive patients who underwent surgical repair of unicoronal plagiocephaly at their institution between 1999 and 2009. In all cases, the senior author (S.R.B.) used a hypercorrection technique for surgical reconstruction. Hypercorrection consisted of significant overcorrection of the affected ipsilateral frontal and anterior temporal areas in the sagittal and coronal planes. Demographic, perioperative, and follow-up data were collected for comparison. The postsurgical appearance of the forehead was documented clinically and photographically and then evaluated and scored by 2 independent graders using the expanded Whitaker scoring system. A relapse was defined as a recurrence of preoperative features that required secondary surgical correction. Results The mean age of the patients at the time of the operation was 13 months (range 8–28 months). The mean follow-up duration was 57 months (range 3 months to 9.8 years). The postsurgical hypercorrection appearance persisted on average 6–8 months but gradually dissipated and normalized. No patients exhibited a relapse of unicoronal plagiocephalic characteristics that required surgical correction. In all cases the aesthetic results were excellent. Only 3 patients required reoperation for the management of persistent calvarial bone defects (2 cases) and removal of a symptomatic granuloma (1 case). Conclusions Our study demonstrates that patients who undergo unicoronal plagiocephaly repair with a hypercorrection surgical technique avoid long-term relapse. Our results suggest that the surgical technique used in the correction of unilateral coronal synostosis is strongly associated with the prevention of postsurgical relapse and that the use of this novel method decreases the need for surgical revision.

scholarly journals A Novel Technique for Reconstruction of a Congenitally Absent Earlobe

2020 ◽  
pp. 014556132097193
Author(s):  
Robert A. Saadi ◽  
Kasra Ziai ◽  
Jessyka G. Lighthall
Keyword(s):  
Congenital Malformations ◽  
Donor Site ◽  
Advancement Flap ◽  
External Ear ◽  
Conchal Cartilage ◽  
Novel Technique ◽  
Cartilage Grafting ◽  
Donor Site Defect ◽  
Rotation Advancement

Objective: Congenital anomalies of the external ear may present a reconstructive challenge, particularly when normal chondrocutaneous components of the auricle fail to develop. Our goal was to develop a novel technique for lobule reconstruction of a congenitally absent earlobe with photographic documentation of the technique. Methods: Informed consent for perioperative photography and publication of case details was obtained. A postauricular, turnover flap with ipsilateral conchal cartilage grafting was performed to reconstruct the lobule, and a superiorly based, postauricular, rotation advancement flap was used to close the donor site defect. Results: Perioperative photographs are included demonstrating technique and cosmetic results. Conclusions: Malformations rarely involve the lobule or lower third of the ear primarily. Literature regarding lobule reconstruction for congenital malformations is scarce. We present a novel technique for lobule reconstruction of a congenitally absent earlobe performed in a single stage that avoids a visible neck scar and allows for simultaneous conchal cartilage harvest. The technique demonstrated satisfactory cosmesis regarding contour and overall appearance and these results remained stable at 1-year follow up.

Primary functional and aesthetic restoration of the fingernail in distal fingertip amputations with the eponychial flap

2013 ◽  
Vol 39 (5) ◽  
pp. 499-504 ◽  
Author(s):  
R. M. Fakin ◽  
A. Biraima ◽  
H. Klein ◽  
P. Giovanoli ◽  
M. Calcagni
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Reconstruction Technique ◽  
Flap Reconstruction ◽  
Growth Disturbance ◽  
Nail Deformity ◽  
Simultaneous Reconstruction ◽  
Aesthetic Results ◽  
The Aesthetic

Fingertip injuries often result in fingernail defects. Reconstruction of this structure is important for adequate functional and aesthetic results. This study evaluates the eponychial flap reconstruction technique in 45 fingertip amputations with loss of more than half the fingernail. In 33 cases the procedure was performed in combination with a palmar island flap for pulp reconstruction. Average follow up was 5 months. All eponychial flaps healed uneventfully. In 44 cases, the pulp volume was restored without nail growth disturbance. Five complications (9%) were observed (pain, soft nail, and nail deformity). Only one hook nail deformity required reoperation. All patients were satisfied with the aesthetic and functional outcome. We found eponychial flap fingernail reconstruction effective even for injuries proximal to the lunula and have extended the indication for this technique to very proximal fingernail defects. Eponychial flap reconstruction is a simple, safe, and time-effective technique without donor site morbidity. Simultaneous reconstruction of dorsal and palmar injuries should both be performed primarily resulting in the restoration of a satisfying fingertip.

scholarly journals Functional and aesthetic outcome with free fibula osteocutaneous flap in reconstruction of anterior mandibular defects in oral malignancies: our experience

2021 ◽  
Vol 7 (9) ◽  
pp. 1438
Author(s):  
Gopika Kalsotra ◽  
Disha Koul ◽  
Arti . ◽  
Parmod Kalsotra ◽  
Rupali Sharma ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Functional Outcome ◽  
Donor Site ◽  
Aesthetic Outcome ◽  
Aesthetic Result ◽  
Post Surgery ◽  
Oral Cavity Carcinoma ◽  
Free Fibula ◽  
The Aesthetic ◽  
Osteocutaneous Flap

<p class="abstract"><strong>Background:</strong> For anterior mandibular defects, vascularized bone flap reconstructions are the best for providing a solid arch necessary to restore form and function, especially in patients receiving tumour excision surgery in head and neck region. Our aim was to study aesthetic and functional outcome of free fibula osteocutaneous flap (FFOCF) in anterior mandibular defects in case of anterior floor of the mouth malignancies with mandibular infiltration.</p><p class="abstract"><strong>Methods:</strong> The clinical data of 15 oral cavity carcinoma patients with involvement of anterior floor of mouth with mandiblular infiltration that underwent FFOCF reconstruction at our institute, government medical college, Jammu, was prospectively collected from January 2018 till January 2020. In this study, the aesthetic and functional outcome of these patients was evaluated at 6 months and 1 year post surgery.</p><p class="abstract"><strong>Results:</strong> The aesthetic result of reconstruction was excellent in most patients. Also, there was no long-term donor-site morbidity. There was no peri-operative death. Flaps survived in all patients. Functional outcomes including the ability to tolerate oral diet and speech outcome were good in all cases.</p><p class="abstract"><strong>Conclusions:</strong> The FFOCF, in reconstruction surgery of advanced oral cavity carcinoma permits more radical resection of tumour with good functional as well aesthetic outcome.</p>

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