Effectiveness of Calcium Hydroxylapatite Paste in Vocal Rehabilitation

2009 ◽  
Vol 118 (8) ◽  
pp. 546-551 ◽  
Author(s):  
M. Boyd Gillespie ◽  
Thomas S. Dozier ◽  
Terry A. Day ◽  
Bonnie Martin-Harris ◽  
Shaun A. Nguyen
Keyword(s):  
Soft Tissue ◽  
Vocal Fold ◽  
Case Series ◽  
Soft Tissue Defects ◽  
Retrospective Case ◽  
Vocal Rehabilitation ◽  
Calcium Hydroxylapatite ◽  
The Voice ◽  
Tissue Defects

Objectives We determined the effectiveness of calcium hydroxylapatite (CaHA) paste in vocal rehabilitation. Methods We examined a retrospective case series of 39 adult patients who underwent CaHA paste injection for vocal fold rehabilitation over a 5-year period. The outcomes included the change in the Voice Handicap Index (VHI) score; procedure-related complications; and the need for follow-up voice procedures. Results The VHI scores demonstrated overall improvement, with a decrease from the preoperative mean of 61.2 ± 24.0 to a postoperative mean of 35.9 ± 26.3 (p = 0.0001) after a mean follow-up time of 17.8 ± 13.6 months. The procedure was more likely to succeed in patients with paralysis and/or paresis than in patients with glottic soft tissue defects. After injection, the VHI scores worsened in 3 of 7 patients (43%) in the soft tissue defect group, compared to only 2 of 28 (7%) in the paralysis and/or paresis group (p = 0.04). Four of 7 patients with soft tissue defects (57%) required secondary vocal procedures to improve the voice, compared to only 2 of 32 (6%) in the paralysis and/or paresis group (p = 0.006). Conclusions Injection of CaHA paste results in significantly improved vocal scores in the majority of patients. Use of the paste was less satisfactory in patients with soft tissue defects because of poor retention of the paste in the scarred vocal fold remnant.

Calcium Hydroxylapatite Paste for Vocal Rehabilitation

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P49-P49
Author(s):  
Marion B Gillespie ◽  
Jason A Curry ◽  
Thomas S Dozier
Keyword(s):  
Vocal Fold ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Vocal Rehabilitation ◽  
Nerve Paralysis ◽  
Calcium Hydroxylapatite ◽  
Laryngeal Nerve Paralysis ◽  
Operative Endoscopy ◽  
The Mean ◽  
The Voice

Objective Determine the effectiveness of calcium hydroxylapatite paste in vocal rehabilitation in routine clinical practice. Methods Retrospective series of adult patients undergoing calcium hydroxylapatite paste injection for vocal fold rehabilitiation over a 3-year period. Outcomes include change in Voice Handicap Index (VHI) scores, procedure-related complications, and need for follow-up vocal procedures. Results A total of 23 patients with an average age of 65 years underwent vocal fold rehabilitation with calcium hydroxylapatite injection performed by operative endoscopy. Indications for injection included recurrent laryngeal nerve paralysis in 17 patients and partial cordectomy defects in 6 patients. There were no observed procedure-related complications. Following injection, 17 patients (74%) had improvement in voice as measured by VHI, 4 had worsening of voice, and 2 were essectially unchanged from baseline. The mean VHI scores improved from 66 (S.D. 4.4) to 35 (S.D. 4.5) after a mean follow-up time of 2 months (p=0.00001). There was a non-significant trend toward greater improvement in the VHI scores for the paralysis group compared to the cordectomy group (p=0.09). Six patients required subsequent vocal procedures after the first injection to improve the voice, 4/6 in the cordectomy group and 2/17 in the paralysis group (p=0.02). Conclusions Calcium hydroxylapatite injection results in significantly improved vocal scores in the majority of patients. The paste was less satisfactory in patients with cordectomy defects due to poor retention of paste in the scarred vocal remnant. External medialization is usually required in these cases in order to adequately mobilize the scar to produce the volume necessary for satisfactory voice.

scholarly journals Soft tissue reconstruction of low voltage electric burn injuries of the thumb and first web space by the first dorsal metacarpal artery island flap: a three-year study from Eastern India

2020 ◽  
Vol 7 (4) ◽  
pp. 1082
Author(s):  
Madhumita Gupta ◽  
Prabir Kumar Jash
Keyword(s):  
Soft Tissue ◽  
Low Voltage ◽  
Burn Injuries ◽  
Soft Tissue Defects ◽  
Dorsal Metacarpal Artery ◽  
Web Space ◽  
Electric Burns ◽  
Tissue Defects ◽  
First Dorsal Metacarpal Artery

Background: Complex soft tissue defects of thumb and first web space are a reconstructive challenge. Low voltage electric burns of the hand commonly result in localised and deep soft tissue destruction. The first dorsal metacarpal artery flap (FDMA) is an attractive local flap option to reconstruct these. This study illustrates our experience with the same.Methods: Between March 2014 and February 2017, 16 patients with complex soft tissue defects of thumb and first web space resulting from low voltage electric burns underwent reconstruction with the FDMA flap and subsequent structured hand therapy. In the follow up visits objective assessment of hand function included tests of mobility using Kapandji Score, sensory evaluation with static 2 point discrimination and cortical reorientation. The Subjective Satisfaction Score was used to ascertain the patient’s overall perception of aesthetic and functional outcome.Results: Majority (43.75%) of the patients had defects involving the thumb IP joint. No case of complete flap failure was noted. In a mean follow-up of 11.5 months the reconstructed thumb showed return of good protective sensation as well as mobility. Though cortical reorientation was complete in only 18.75 %, it did not substantially impede hand functioning. All patients were satisfied with the functional and aesthetic result.Conclusions: In cases of low voltage electric burn injuries the FDMA flap is a reliable reconstructive option for small to moderate sized complex defects of thumb and first web space. It has minimal donor site morbidity and can be accomplished in a relatively simple single stage procedure.

scholarly journals Ad hoc posterior tibial vessels perforator propeller flaps for the reconstruction of lower third leg soft- tissue defects

2017 ◽  
Vol 50 (03) ◽  
pp. 281-287
Author(s):  
Thalaivirithan Margabandu Balakrishnan ◽  
Jayagosh Ramkumar ◽  
Janardhanan Jaganmohan
Keyword(s):  
Retrospective Study ◽  
Soft Tissue ◽  
Ad Hoc ◽  
Soft Tissue Defects ◽  
Secondary Procedure ◽  
Posterior Tibial ◽  
Minimal Scarring ◽  
Tissue Defects

ABSTRACT Introduction: Lower third leg soft tissue defects with anatomical and pathological constraints are posing formidable challenges to reconstructive surgeon. Aim: This retrospective study was conducted to assess the effectiveness of ad hoc posterior tibial vessels perforator-propeller flaps for the reconstruction of small and medium sized soft tissue defects in the lower third leg. Patients and Methods: 22 patients (16 were males and 6 were females) were involved in this study between period of January 2012 and December 2016. We followed the protocol of initial non delineating exploratory incision made to find out single best perforator in all patients. All the defects in leg reconstructed with adhoc posterior tibial vessel propeller flaps. Results: All 22 flaps survived well. All in an average of 13 months follow up period, had pain free walking, with minimal scarring and acceptable aesthesis at the reconstruction sites with no need for any secondary procedure. Conclusion: With inability of preoperatively dopplering the perforators in the lower third leg region, the exploratory posterior nondelineating incision was used in all cases to secure the single best perforator for the propeller flaps. Thus adhoc posterior tibial vessel propeller flaps are dependable, easily adoptable for the reconstruction of soft tissue defects of the lower third leg region.

scholarly journals Adipofascial perforator flaps: Its role in reconstruction of soft-tissue defects of lower leg and ankle

2018 ◽  
Vol 51 (02) ◽  
pp. 216-221 ◽  
Author(s):  
Deepak Nanda ◽  
Shamendra Anand Sahu ◽  
Durga Karki ◽  
Sanjay Kumar ◽  
Amrita Mandal
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Donor Site ◽  
Soft Tissue Defect ◽  
Soft Tissue Defects ◽  
Adipofascial Flap ◽  
Tibial Artery ◽  
Split Skin ◽  
Tissue Defects

ABSTRACT Background: Despite advances in surgical skills, adipofascial flaps are still less preferred option for coverage of leg defect. We evaluate the use of perforator-based adipofascial flap in small-to-medium-sized soft-tissue defects in the lower limb. Patients and Methods: After localisation of perforators along the major axial vessels in the lower limb using handheld Doppler, adipofascial flap based on the nearest best perforator of anterior tibial artery, posterior tibial artery and peroneal artery was raised to cover soft-tissue defect in 21 patients. The flap was transposed over the defect and covered by split-skin graft. Donor site was primarily closed. Flap complications, functional and aesthetic outcomes are noted in follow-up. Results: There was partial loss of flap in five patients. After debridement and dressings, split-skin grafting was done for four patients and one patient was managed with local flap. Scar over the flap was stable with no reports of recurrent ulceration or breakdown of wound in 6-month follow-up. Four of five patients reported adequate healing of the fractured bone. Average visual analogue score was 8.24/10 for appearance of donor site as evaluated by the patient. Conclusions: Perforator-based adipofascial flap is a good alternative for coverage of small-to-medium-sized soft-tissue defect of the leg, particularly over the malleolus and lower part of the leg. Use of adipofascial tissue and primary closure of the donor site causes minimal donor-site morbidity. Adipofascial perforator flap provides aesthetically superior recipient-site scar with satisfactory functional outcome.

scholarly journals Bone Transport for Treatment of Traumatic Composite Tibial Bone and Soft Tissue Defects: Any Specific Needs besides the Ilizarov Technique?

2020 ◽  
Vol 2020 ◽  
pp. 1-13 ◽  
Author(s):  
Runguang Li ◽  
Guozheng Zhu ◽  
Chaojie Chen ◽  
Yirong Chen ◽  
Gaohong Ren
Keyword(s):  
Soft Tissue ◽  
Deep Infection ◽  
Bone Transport ◽  
Fixation Time ◽  
Ilizarov Technique ◽  
Soft Tissue Defects ◽  
Flap Surgery ◽  
Tibial Bone ◽  
Tissue Defects

Objective. To evaluate the surgical efficacy of bone transport (Ilizarov technique) plus “shortening-lengthening,” “flap surgery,” and “open bone transport” as individualized treatments for traumatic composite tibial bone and soft tissue defects. Methods. We retrospectively analyzed sixty-eight cases (mean age: 35.69 years, (range, 16–65)) treated from July 2014 to June 2017, including 29 middle, 18 distal, and 21 proximal tibial bone defects (4–18 cm, mean: 7.97 cm) with soft tissue defects (2.5 cm × 4.0 cm to 30.0 cm × 35.0 cm after debridement). We adopted the bone transport external fixator to fix the fracture after debriding the defect parts. In the meantime, we adopted the “shortening-lengthening technique,” “flap surgery,” and “open bone transport” as individualized treatment based on the location, range, and severity of the composite tibial bone and soft tissue defects. Postoperative follow-up was carried out. Surgical efficacy was assessed based on (1) wound healing; (2) bone defect healing rate; (3) external fixation time and index; (4) incidence/recurrence of deep infection; (5) postoperative complications; and (6) Association for the Study and Application of the Methods of Ilizarov (ASAMI) score. Results. The mean duration from injury to reconstruction was 22 days (4–80 d), and the mean postoperative follow-up period was 30.8 months (18–54 m). After the repair and reconstruction, 2 open bone transport patients required infected bone removal first before continuing the bone transport treatment. No deep infection (osteomyelitis) occurred or recurred in the remaining patients, and no secondary debridement was required. Some patients had complications after surgery. All the postoperative complications, including flap venous crisis, nail channel reaction, bone nonunion, mechanical axis deviation, and refracture, were improved or alleviated. External fixation time was 12.5 ± 3.41 months, and the index was 1.63 ± 0.44. According to the ASAMI score, 76.47% of the outcomes were good/excellent. Conclusion. The Ilizarov technique yields satisfactory efficacy for composite tibial bone and soft tissue defects when combined with “shortening-lengthening technique,” “flap surgery,” and “open bone transport” with appropriate individualized treatment strategies.

scholarly journals Orbital Tumors Excision without Bony Marginotomy under Local and General Anesthesia

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Robert A. Goldberg ◽  
Daniel B. Rootman ◽  
Nariman Nassiri ◽  
David B. Samimi ◽  
Joseph M. Shadpour
Keyword(s):  
Soft Tissue ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Case Series ◽  
Ocular Motility ◽  
Orbital Tumors ◽  
Retrospective Case ◽  
Fibrous Tumor ◽  
Orbital Varix

To present our experience of removing middle to deep orbital tumors using a combination of minimally invasive soft tissue approaches, sometimes under local anesthesia.Methods.In this retrospective case series, 30 patients (13 males and 17 females) underwent tumor removal through eyelid crease (17 eyes), conjunctival (nine eyes), lateral canthal (two eyes), and transcaruncular (two eyes) approaches. All tumors were located in the posterior half of the orbit. Six cases were removed under monitored anesthesia care with local block, and 24 were under general anesthesia.Results.The median (range) age and follow-up duration were 48.5 (31–87) years old and 24.5 (4–375) weeks, respectively. Visual acuity and ocular motility showed improvement or no significant change in all but one patient at the latest followup. Confirmed pathologies revealed cavernous hemangioma (15 cases), pleomorphic adenoma (5 cases), solitary fibrous tumor (4 cases), neurofibroma (2 cases), schwannoma (2 cases), and orbital varix (1 case). None of the patients experienced recurrence.Conclusions.Creating a bony marginotomy increases intraoperative exposure of the deep orbit but adds substantial time and morbidity. Benign orbital tumors can often be removed safely through small soft-tissue incisions, without bone removal and under local anesthesia.

Candidiasis Causing Vocal Fold Leukoplakia: Review of Clinical and Pathological Results of 289 Cases With Vocal Fold Leukoplakia

2019 ◽  
Vol 128 (10) ◽  
pp. 903-910 ◽  
Author(s):  
Murat Gumussoy ◽  
Ulku Kucuk
Keyword(s):  
Vocal Fold ◽  
Inhaled Corticosteroids ◽  
Medical Center ◽  
Age Groups ◽  
Significant Risk ◽  
Case Series ◽  
Predisposing Factors ◽  
Retrospective Case ◽  
Vocal Fold Leukoplakia

Objective: In laryngology practice, vocal fold leukoplakia is frequently evaluated by suspension laryngoscopy and biopsy examination upon the patient’s complaints of hoarseness and dysphonia. The purpose of the present study is to investigate and analyze risk factors, diagnosis, treatment, and follow-up results of cases with Candida leukoplakia. Study Design: Retrospective case control study. Setting: Tertiary medical center. Subjects and Methods: Patients with a diagnosis of vocal fold leukoplakia who underwent direct laryngoscopy and biopsy between 2007 and 2017 and diagnosed as candida or noncandida in their histopathology were assigned into 2 groups. Then they were compared in terms of their demographic characteristics, predisposing factors, diagnosis, treatment, and follow-up results. Results: Of the 289 vocal fold leukoplakia cases, 36 were candida, and 253 were noncandida. The mean age of the patients with Candida leukoplakia was 60.86 years. As for the age groups, the largest group (26.1%) was in the seventh decade ( P < .001). The use of inhaled corticosteroids was a significant risk factor ( P < .001). For their medical therapy, the patients were administered fluconazole 200 mg per day for 3 weeks, and the treatment yielded successful results in 91.66% of them. In 5 of the patients, candida leukoplakia and superficial epithelial dysplasia were observed, and no malignant transformation was observed during a mean follow-up of 28 ± 13 months. Conclusion: Candidiasis causing vocal fold leukoplakia is rare, and we report the findings of the largest published case series to date. Eliminating predisposing factors and administrating oral fluconazole 200 mg for 3 weeks are sufficient for medical treatment.

Definitive reconstruction of complex maxillofacial trauma with wide-spread soft-tissue defects: A case series

2021 ◽  
Author(s):  
Hong Loi Nguyen
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Case Series ◽  
Maxillofacial Trauma ◽  
Soft Tissue Defects ◽  
Wide Spread ◽  
Severe Injuries ◽  
Tissue Defects

The mаnаgement of soft tissue injury аfter complex fаciаl trаumа poses unique chаllenges to the plаstic surgeon, given the speciаlized nаture of fаciаl tissue аnd the аesthetic importаnce of the fаce. We report 8 cаses with wide-spreаd soft-tissue defects due to complex fаciаl trаumаwho presented аt Odontostomаtology center - Hue centrаl hospitаl during the yeаr 2018.Of these cаses were surgicаlly mаnаged by fixаtion аnd fаciаl reconstructionаt Odonto-stomаtology center - Hue centrаl hospitаl;аnd they were very well recovery in function аnd аesthetics. The generаl principles of trаumа mаnаgement аnd wound cаre аre аpplied in аll cаses. The mаnаgement of severe injuries to the fаce is discussed in relаtion to the locаtion аnd the mechаnism of injury.

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