Reconstruction of the Columella with Bilateral Nostril Sill Flaps

2006 ◽  
Vol 115 (3) ◽  
pp. 239-242 ◽  
Author(s):  
Zühtü Demir ◽  
Kubilay Özdil ◽  
Sebat Karamürsel ◽  
Serdar Yüce ◽  
Fatih Öktem ◽  
...  
Keyword(s):  
Pediatric Patient ◽  
Single Stage ◽  
Cosmetic Result ◽  
One Stage ◽  
First Choice ◽  
Aesthetic Results ◽  
Excellent Color ◽  
Texture Match

The treatment of total columellar defects is very difficult, and there is not any first choice in reconstruction of these defects. Various techniques have been reported for this purpose. Each technique has its own drawbacks, and few can be performed in one stage. We report a pediatric patient with a defect involving the entire columella. Reconstruction of the defect was accomplished with laterally based bilateral nostril sill flaps. An acceptable cosmetic result was obtained. This method can be done as a single-stage operation with an excellent color and texture match. We think that this method leads to good aesthetic results, and should be considered for total columellar reconstruction.

Results at 10–24 years after single-stage revision arthroplasty of infected total hip arthroplasty in patients under 45 years of age

2019 ◽  
pp. 112070001988887 ◽  
Author(s):  
Matthias Wolff ◽  
Christian Lausmann ◽  
Thorsten Gehrke ◽  
Akos Zahar ◽  
Malte Ohlmeier ◽  
...  
Keyword(s):  
Infection Control ◽  
Revision Surgery ◽  
Single Stage ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Study Cohort ◽  
One Stage ◽  
The Mean

Introduction: The management of periprosthetic joint infection (PJI) of the hip is a challenging procedure. One-stage exchange is carried out in specialist centres with comparable infection free survival rates. However, there is a paucity of long-term results of this approach in young patients. Methods: All patients undergoing one-stage exchange due to PJI with a known causative organism ⩽45 years of age with a minimum of 10-year follow-up (mean 15 years; range 10–24 years) were enrolled in this retrospective study. Patients older than 45 years of age or patients with a two-stage procedure were excluded from the study. The primary outcome measure was failure rate with special focus on reinfection at latest follow-up. Failure was defined as revision surgery for infection. Furthermore, functional outcome using the Harris Hip Score was determined initially and at latest follow-up. 26 patients fulfilled the inclusion criteria and were available for final follow-up. Results: The study cohort consists of 16 male and 10 female patients with a mean age of 36.8 years (range 20–45 years) and a mean BMI of 29.8 kg/m2 (range 20.7–40.6 kg/m2). Prior to the single-stage procedure, the patients underwent an average of 3.1 previous surgical interventions (range 1–9). The mean hospital stay after septic revision was 19.7 days (11–33 days). Most infections were caused by Staphylococcus epidermidis ( n = 8, 30.8%), followed by Staph. aureus ( n = 7, 26.9%) and Propionibacterium acnes ( n = 6, 23.1%). At latest follow-up, the overall survival rate was 76.9 %, while infection control could be achieved in 96.2%. At final examination, the mean Harris Hip Score improved from 46.2 to 78.9 (range 18.0–99; SD, 22.6). Conclusions: Single-stage revision surgery for the management of PJI in patients ⩽45 years is a successful treatment option with high infection control, even after long-term follow-up.

scholarly journals Occipitoaxial spinal interarticular stabilization with vertebral artery preservation for atlantal lateral mass failure

2015 ◽  
Vol 22 (2) ◽  
pp. 134-138 ◽  
Author(s):  
Lukas Bobinski ◽  
Marc Levivier ◽  
John M. Duff
Keyword(s):  
Vertebral Artery ◽  
Tumor Resection ◽  
Craniocervical Junction ◽  
Single Stage ◽  
Lateral Mass ◽  
One Stage ◽  
Craniocervical Instability ◽  
Mass Failure ◽  
Titanium Cages ◽  
Mass Reconstruction

The treatment of craniocervical instability caused by diverse conditions remains challenging. Different techniques have been described to stabilize the craniocervical junction. The authors present 2 cases in which tumoral destruction of the C-1 lateral mass caused craniocervical instability. A one-stage occipitoaxial spinal interarticular stabilization (OASIS) technique with titanium cages and posterior occipitocervical instrumentation was used to reconstruct the C-1 lateral mass and stabilize the craniocervical junction. The ipsilateral vertebral artery was preserved. The OASIS technique offers single-stage tumor resection, C-1 lateral mass reconstruction, and stabilization with a loadsharing construct. It could be an option in the treatment of select cases of C-1 lateral mass failure.

Pediatric Cholesteatoma: An Individualized, Single-Stage Approach

1996 ◽  
Vol 115 (1) ◽  
pp. 107-114 ◽  
Author(s):  
Simon C. Parisier ◽  
Matthew B. Hanson ◽  
Jin C. Han ◽  
Adam J. Cohen ◽  
Bryan A. Selkin
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Nerve Injury ◽  
Single Stage ◽  
Canal Wall ◽  
Facial Nerve Injury ◽  
Related Disease ◽  
One Stage ◽  
Canal Wall Down ◽  
Pediatric Cholesteatoma

We report our experience with a one-stage surgery for pediatric cholesteatoma in 216 ears. Our technique is based on three main principles: (1) the surgery is individualized; (2) the goal of surgery is to completely remove cholesteatoma and related disease in one operation; and (3) the reconstruction is performed to provide both good hearing and a dry, trouble-free ear. The incidence of recidivism was 10.2%, and the rate achieved was 13.3% at 5 years and 24% at 10 years. Canal wall down surgery was the predominant procedure used. The incidence of intraoperative neurosensory hearing loss, vertigo, and facial nerve injury was extremely low. The postoperative cavity problems encountered were minimal.

scholarly journals Frontoethmoidal Encephalomeningocele Revisited : The Convenience Of Teamwork Approach, A CaseSeries

1970 ◽  
Vol 1 (5) ◽  
Author(s):  
Nadia Kusumastuti ◽  
Siti Handayani ◽  
Mendy Hatibie ◽  
Enrina Diah ◽  
Kristaninta Bangun
Keyword(s):  
Reconstructive Surgery ◽  
Case Series ◽  
Plastic Surgeon ◽  
Congenital Defect ◽  
Single Stage ◽  
Surgical Correction ◽  
The Other ◽  
Defect Correction ◽  
Plastic And Reconstructive Surgery ◽  
Aesthetic Results

Background: Frontoethmoidal encephalomeningocele (FEEM) is a congenital defect of the skull which poses many problems to the patient as it results in many craniofacial and neural morbidities. While recently surgical correction of this disease is done in a single-stage procedure, many in Indonesia still perform twostage surgery which bears more risks and is technically difficult to achieve good aesthetic results. This case series intend to assess the feasibility and convenience of teamwork approach between plastic surgeon and neurosurgeon in correcting FEEM in a single-stage operation. Methods:We reviewed 8 patients with FEEM treated in Plastic and Reconstructive Surgery Division, Cipto Mangunkusumo Hospital Jakarta from November 2005 until March 2010. Four of the cases were secondary cases from Neurosurgery Department, and the other 4 cases were treated in single-stage operation, in teamwork with Neurosurgery Department, using the Chula technique. Results of each surgery was assessed using objective parameters, which are Intercanthal Distance (ICD) and Interorbital Distance (IOD); and also subjective parameters which is aesthetic improvement.Result: All of the patients showed significant improvements in ICD and IOD measurements. No complication was found intra and post-operatively. All patients, especially the ones treated with singlestage surgery show good aesthetic results. Conclusion: To achieve goals of defect correction and aesthetically pleasant appearance, single-stage surgery in teamwork with the neurosurgery department seems to be most suitable and convenient.

scholarly journals Single-stage revision for the infected total knee arthroplasty

2021 ◽  
Vol 2 (5) ◽  
pp. 305-313
Author(s):  
Nima Razii ◽  
Juliet M. Clutton ◽  
Rahul Kakar ◽  
Rhidian Morgan-Jones
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Single Stage ◽  
Tissue Loss ◽  
One Stage ◽  
Total Knee ◽  
Revision Tka ◽  
Culture Negative

Aims Periprosthetic joint infection (PJI) is a devastating complication following total knee arthroplasty (TKA). Two-stage revision has traditionally been considered the gold standard of treatment for established infection, but increasing evidence is emerging in support of one-stage exchange for selected patients. The objective of this study was to determine the outcomes of single-stage revision TKA for PJI, with mid-term follow-up. Methods A total of 84 patients, with a mean age of 68 years (36 to 92), underwent single-stage revision TKA for confirmed PJI at a single institution between 2006 and 2016. In all, 37 patients (44%) were treated for an infected primary TKA, while the majority presented with infected revisions: 31 had undergone one previous revision (36.9%) and 16 had multiple prior revisions (19.1%). Contraindications to single-stage exchange included systemic sepsis, extensive bone or soft-tissue loss, extensor mechanism failure, or if primary wound closure was unlikely to be achievable. Patients were not excluded for culture-negative PJI or the presence of a sinus. Results Overall, 76 patients (90.5%) were infection-free at a mean follow-up of seven years, with eight reinfections (9.5%). Culture-negative PJI was not associated with a higher reinfection rate (p = 0.343). However, there was a significantly higher rate of recurrence in patients with polymicrobial infections (p = 0.003). The mean Oxford Knee Score (OKS) improved from 18.7 (SD 8.7) preoperatively to 33.8 (SD 9.7) at six months postoperatively (p < 0.001). The Kaplan-Meier implant survival rate for all causes of reoperation, including reinfection and aseptic failure, was 95.2% at one year (95% confidence interval (CI) 87.7 to 98.2), 83.5% at five years (95% CI 73.2 to 90.3), and 78.9% at 12 years (95% CI 66.8 to 87.2). Conclusion One-stage exchange, using a strict debridement protocol and multidisciplinary input, is an effective treatment option for the infected TKA. This is the largest single-surgeon series of consecutive cases reported to date, with broad inclusion criteria. Cite this article: Bone Jt Open 2021;2(5):305–313.

scholarly journals Local facial flaps: a workhorse for reconstruction of facial malignancies defects

2019 ◽  
Vol 5 (3) ◽  
pp. 755
Author(s):  
Nikita G. Rolekar ◽  
Pradeep Goil ◽  
Jagdeep Rao
Keyword(s):  
Cell Carcinoma ◽  
Advancement Flap ◽  
Medium Size ◽  
Limberg Flap ◽  
Aesthetic Result ◽  
Skin Malignancy ◽  
Facial Defects ◽  
Aesthetic Results ◽  
Texture Match ◽  
Good Aesthetic Result

<p class="abstract"><strong>Background:</strong> Face represents complete personality of a human being, so adequate cosmetic correction of facial defects arising due to skin malignancy is very important. After excision, treatment option varies according to size and location of defect for small- or moderately-sized circular defects. In our study, we have evaluated versatility of local flap of face.</p><p class="abstract"><strong>Methods:</strong> We have included 30 cases of skin malignancy on face in our Institute within the period of June 2016 to May 2018. 20 patients (66.6%) were male and 10 patients (33.3%) were female, in age group from 45 to 65 years. 17 cases had basal cell carcinoma, 10 cases had squamous cell carcinoma and 3 cases had malignant melanoma. Tumours were excised with safe margins and defects reconstructed with local facial flaps. We evaluated the early postoperative complications and after 6months, cosmetic outcome and patient satisfaction was evaluated.  </p><p class="abstract"><strong>Results:</strong> 30 patients with small to medium-sized defect (3-6 cm), 8 cases were managed with V-Y advancement flap, 7 cases nasolabial flap, 8 cases forehead flap and, 4 cases Limberg flap, 4 cases cheek advancement flap. Postoperatively none of the cases had complications and the functional and aesthetic outcomes were quite acceptable. Aesthetic results were excellent in 15 patients (50%), while in 8 patients good results (27%) and 5 patient fair results (17%) after 6 month.</p><p class="abstract"><strong>Conclusions:</strong> Local facial flaps are the simple and best option to reconstruct the small to medium size facial malignancies defects and provides excellent skin colour and texture match with gives good aesthetic result.</p>

scholarly journals The Naso-labial and lateral forehead flaps as a single stage: A case report and review of literature

2008 ◽  
Vol 41 (02) ◽  
pp. 171-174
Author(s):  
A. I. Adigun ◽  
A. O. Oladele ◽  
J. K. Olabanji
Keyword(s):  
Road Traffic ◽  
Civil Servant ◽  
Road Traffic Injury ◽  
Complete Loss ◽  
Single Stage ◽  
Nasal Reconstruction ◽  
Review Of Literature ◽  
Traffic Injury ◽  
Paramedian Forehead Flap ◽  
Aesthetic Results

ABSTRACTWe present here the case of a patient with a major traumatic nasal loses who had a near-total nasal reconstruction as a single-stage procedure. A 35 year-old civil servant who was involved in a road traffic injury about two years before presentation. He sustained extensive and multiple facial injuries with complete loss of nasal cover and lining. Reconstruction was performed by using superiorly based, bilateral, nasolabial flaps to line the floor and the nasal septum, and a paramedian forehead flap for skin cover. The patient did well postoperatively and was discharged home on the 7 th postoperative day. If the principles concerning cover, support, and lining are adhered to, excellent functional and aesthetic results can be achieved as we have obtained in our patient.

Single-stage PN/A technology treating saline ammonia-rich wastewater: finding the balance between efficient performance and less N2O and NO emissions

RSC Advances ◽  
2016 ◽  
Vol 6 (114) ◽  
pp. 113152-113162 ◽  
Author(s):  
Yuan Yan ◽  
Yayi Wang ◽  
Yu Chen ◽  
Ximao Lin ◽  
Min Wu ◽  
...  
Keyword(s):  
Single Stage ◽  
One Stage ◽  
Elevated Salinity ◽  
Efficient Performance ◽  
First Time ◽  
No Emissions

N2O emission from a one-stage PN/A process was studied for the first time with elevated salinity.

One Stage and Two Stage Vibration Isolators as Applied to High Speed Textile Spindles to Achieve Noise Reduction

1978 ◽  
Vol 100 (1) ◽  
pp. 33-40 ◽  
Author(s):  
L. W. Foster
Keyword(s):  
Low Noise ◽  
Single Stage ◽  
Sound Power ◽  
Octave Band ◽  
Noise Levels ◽  
Two Stage ◽  
Noise And Vibration ◽  
Vibration Isolators ◽  
One Stage ◽  
The Impact

The operation of ring spinning frames in textile mills can create spinning room noise levels of 90 to 95 dBA. The spindle bobbin mechanisms (generally 300 to 400 per machine) which are operated at spindle speeds of 6,000 to 14,000 rpm are major sources of noise in this type of machinery. The rotating unbalance force in the spindle-bobbin mechanism creates high frequency vibrations in the spindle blade and in the spindle bolster which contains the bearings on which the blade rotates. The vibrations generated by the spindle bobbin mechanism and the bearings are transmitted through the spindle bolster to the rail structure of the spinning frame where they cause sand energy to be radiated. This paper describes the use of two types of elastomeric vibration isolators located between the spindle bolster and the rail to achieve reductions of vibration and noise levels associated with the spindle-bobbin-rail subsystem of spinning frames. The two types of elastomeric isolators employed are: (1) a single-stage isolator where a bonded elastomeric mounting of annular design is placed between the bolster and the rail, and (2) a two-stage isolator which incorporates an annular intermediate mass element between two annular elastomeric sections that provide the interfaces to the spindle and to the rail. The two stage isolator is a novel design for rotating spindle type applications and employs the classical two stage isolator principle to achieve greater attenuation of vibrations. While it has been known for some time that single stage elastomeric isolators provide an effective means of reducing vibrations and noise in textile spinning and twisting machines, recent emphasis on reducing machine noise levels has motivated increased effort to better describe and apply elastomeric isolators. The two-stage isolator concept has been employed in an attempt to achieve higher operating speeds and, therefore, higher productivity while keeping noise levels within acceptable limits. In order to demonstrate the degrees of noise and vibration reductions that can be attained using the two types of isolators in comparison with the non-isolated or hard-mounted spindle, tests were performed using a single oil base type spinning spindle with a full bobbin. The spindle-bobbin mechanism was mounted to a representative rail by the three mounting methods described previously and operated at speeds of 11,000 rpm and 14,000 rpm in a reverberation room. Octave band sound power level measurements and one-tenth octave band sound pressure measurements were made to compare the performance of the mounting methods. These measurements were made using six microphones at different locations and sampling their output signals at a high rate over an extended interval of time. One-tenth octave horizontal and vertical rail acceleration responses were obtained concurrently with the noise responses. These noise and vibration responses are presented and discussed in the paper. The results show that the elastomeric isolators provide significant reductions in rail vibration response levels in the spindle bearing vibration frequency range of 500 to 2000 Hz. The corresponding overall sound power levels for the two operating speeds when using one stage isolators were 8 to 18 dBA below the hard-mounted spindle condition. When using the two-stage isolator, the overall sound power levels for the two operating speeds were 9 and 20 dBA below the hard mounted spindle condition. The results demonstrate the importance of properly designing the mounting to tune the system for low noise responses while minimizing the impact on other operatonal criteria such as spindle static deflection and dynamic motion. A discussion of the isolator design parameter trade-offs is presented along with comments regarding the limitations of the testing and the constraints involved in predicting the noise level reduction to be expected for a whole spinning frame.

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