Cheek Dimpleplasty: A New Classification of Described Procedures

Cheek dimpleplasty has become a popular request amongst patients requesting cosmetic surgery. Since the first reported dimpleplasty in 1962, there have been many reported procedures in the literature for cheek dimple creation. Some of the procedures described by various authors as “novel” are actually similar if not identical to existing procedures. This study reviews the different procedures of cheek dimple creation and provides the first ever systematic classification for these techniques. EMBASE, Cochrane library, Ovid medicine, and PubMed databases were searched from its inception to June of 2019. We included all studies describing the surgical creation of cheek dimples. The studies were reviewed, and the different procedures were cataloged. We then proposed a new classification system for these procedures based on their common characteristics. The study included 12 articles published in the English language that provided a descriptive procedure for cheek dimple creation. We classified the procedures into 3 broad categories and subcategories. Type 1 procedures are nonexcisional myocutaneous dimpleplasties. In these procedures, the buccinator muscle is not excised. In type 1A, the suture used to create the adhesion traverses the epidermis. In type 1B, the suture does not traverse the epidermis, rather, the suture travels up into the dermis and returned back to the mucosa. Type 2 procedures are excisional dimpleplasties. In these procedures, the buccinator muscle is excised with (open) or without (closed) the excision of the mucosa. Type 3 procedures are incisional dimpleplasty. In these procedures, the muscle is incised and fixed to the dermis. Each of these groups of procedures has potential unique advantages and disadvantages. There are multiple procedures reported in the English language literature for the creation of cheek dimples. Most of the procedures are based on similar concept with minor variations. Our classification system, the Opoku-Simone Classification, will help facilitate communication when describing the different configurations of these procedures. Procedure within each group has similar potential advantages and disadvantages.

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Surgical Configurations of the Pectoralis Major flap for Reconstruction of Sternoclavicular Defects: A Systematic Review and New Classification of Described Techniques

10.21203/rs.2.11054/v1 ◽

2019 ◽

Author(s):

Jude Opoku-Agyeman ◽

David Matera ◽

Jamee Simone

Keyword(s):

Classification System ◽

English Language ◽

Pectoralis Major ◽

Cochrane Library ◽

New Classification ◽

Pectoralis Major Flap ◽

Defect Reconstruction ◽

Type 3

Abstract Objectives The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques. Methods EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to November of 2018. We included all studies describing surgical management of sternoclavicular defects. The studies were reviewed, and the different configurations of the pectoralis major flap used for sternoclavicular defect reconstruction were cataloged. We then proposed a new classification system for these procedures. Results The study included 5 articles published in the English language that provided a descriptive procedure for the use of pectoralis major flap in the reconstruction of sternoclavicular defects. The procedures were classified into three broad categories. In Type 1, the whole pectoris muscle is used. In Type 2, the pectoralis muscle is split and either advanced medially (type 2a) or rotated (type 2b) to fill the defect. In type 3, the clavicular portion of the pectoralis is islandized on a pedicle, either the TAA (type 3a) or the deltoid branch of the TAA (type 3b). Conclusion There are multiple configurations of the pectoralis flap reported in the English language literature for the reconstruction of sternoclavicular defects. Our classification system will help facilitate communication when describing the different configurations of the pectoralis major flap for reconstruction of sternoclavicular joint defects.

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A Novel Country Classification System for Choosing International Business Locations

International Business Research ◽

10.5539/ibr.v13n1p29 ◽

2019 ◽

Vol 13 (1) ◽

pp. 29

Author(s):

Mikidadu Mohammed ◽

Jean Marie Luundo

Keyword(s):

Political Economy ◽

International Business ◽

Classification System ◽

New Classification ◽

International Investments ◽

Doing Business ◽

Legal Risks ◽

Political Economic ◽

Type 3

This paper introduces a novel country classification system that rates the political economy risks of countries for the purpose of conducting international business. It is intended to provide investors, multinational companies, and business researchers a quick and efficient way of gauging the extent of political, economic, and legal risks associated with doing business in different countries. The study covers over 170 countries and identifies 24 country types. At the extremes are Type 1 countries (least risky) and Type 24 countries (most risky). Overall, the new classification system suggests that political economy risks associated with doing international business are relatively mild in Type 1, Type 3, and Type 4 countries. However, international businesses should temper their investment decisions with caution in Type 19, Type 20, Type 22, Type 23, and Type 24 countries due to high political, economic, and legal risks, especially Types 23 and 24 where these risks are excessive. At the same time, international businesses may want to refocus their attention to Type 11 countries who are now havens for international investments due to drastic reduction in political, economic, and legal risks associated with doing business. The twenty-four country types identified in this new classification system are time-invariant. Thus, countries may move up or down due to improvements or deteriorations in certain aspects of their political economy.

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Surgical Configurations of the Pectoralis Major flap for Reconstruction of Sternoclavicular Defects: A Systematic Review and New Classification of Described Techniques

10.21203/rs.2.11054/v2 ◽

2019 ◽

Author(s):

Jude Opoku-Agyeman ◽

David Matera ◽

Jamee Simone

Keyword(s):

Classification System ◽

English Language ◽

Sternoclavicular Joint ◽

Pectoralis Major ◽

Cochrane Library ◽

New Classification ◽

Pectoralis Major Flap ◽

Thoracoacromial Artery ◽

Defect Reconstruction ◽

Reconstruction Methods

Abstract Objectives : The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques. We also provide an algorithm for the selection of these flap variants for sternoclavicular defect reconstruction Methods : EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to August of 2019. We included all studies describing surgical management of sternoclavicular defects. The studies were reviewed, and the different configurations of the pectoralis major flap used for sternoclavicular defect reconstruction were cataloged. We then proposed a new classification system for these procedures. Results : The study included 6 articles published in the English language that provided a descriptive procedure for the use of pectoralis major flap in the reconstruction of sternoclavicular defects. The procedures were classified into three broad categories. In Type 1, the whole pectoris muscle is used. In Type 2, the pectoralis muscle is split and either advanced medially (type 2a) or rotated (type 2b) to fill the defect. In type 3, the clavicular portion of the pectoralis is islandized on a pedicle, either the thoracoacromial artery (type 3a) or the deltoid branch of the thoracoacromial artery (type 3b). Conclusion: There are multiple configurations of the pectoralis flap reported in the English language literature for the reconstruction of sternoclavicular defects . Our classification system, The Opoku Classification will help surgeons select the appropriate configuration of the pectoralis major flap for sternoclavicular joint defect reconstruction based on size of defect, the status of the vascular anatomy, and acceptability of upper extremity disability. It will also help facilitate communication when describing the different configurations of the pectoralis major flap for reconstruction of sternoclavicular joint defects.

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Surgical configurations of the pectoralis major flap for reconstruction of sternoclavicular defects: a systematic review and new classification of described techniques

BMC Surgery ◽

10.1186/s12893-019-0604-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Jude Opoku-Agyeman ◽

David Matera ◽

Jamee Simone

Keyword(s):

Classification System ◽

English Language ◽

Vascular Anatomy ◽

Sternoclavicular Joint ◽

Pectoralis Major ◽

Cochrane Library ◽

New Classification ◽

Pectoralis Major Flap ◽

Thoracoacromial Artery ◽

Defect Reconstruction

Abstract Objectives The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques. We also provide an algorithm for the selection of these flap variants for sternoclavicular defect reconstruction. Methods EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to August of 2019. We included all studies describing surgical management of sternoclavicular defects. The studies were reviewed, and the different configurations of the pectoralis major flap used for sternoclavicular defect reconstruction were cataloged. We then proposed a new classification system for these procedures. Results The study included 6 articles published in the English language that provided a descriptive procedure for the use of pectoralis major flap in the reconstruction of sternoclavicular defects. The procedures were classified into three broad categories. In Type 1, the whole pectoris muscle is used. In Type 2, the pectoralis muscle is split and either advanced medially (type 2a) or rotated (type 2b) to fill the defect. In type 3, the clavicular portion of the pectoralis is islandized on a pedicle, either the thoracoacromial artery (type 3a) or the deltoid branch of the thoracoacromial artery (type 3b). Conclusion There are multiple configurations of the pectoralis flap reported in the English language literature for the reconstruction of sternoclavicular defects. Our classification system, the Opoku Classification will help surgeons select the appropriate configuration of the pectoralis major flap for sternoclavicular joint defect reconstruction based on size of defect, the status of the vascular anatomy, and acceptability of upper extremity disability. It will also help facilitate communication when describing the different configurations of the pectoralis major flap for reconstruction of sternoclavicular joint defects.

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Surgical Configurations of the Pectoralis Major flap for Reconstruction of Sternoclavicular Defects: A Systematic Review and New Classification of Described Techniques

10.21203/rs.2.11054/v3 ◽

2019 ◽

Author(s):

Jude Opoku-Agyeman ◽

David Matera ◽

Jamee Simone

Keyword(s):

Classification System ◽

English Language ◽

Sternoclavicular Joint ◽

Pectoralis Major ◽

Cochrane Library ◽

New Classification ◽

Pectoralis Major Flap ◽

Thoracoacromial Artery ◽

Defect Reconstruction ◽

Reconstruction Methods

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Review of Suppes 1957 Proposals For Division by Zero

Transmathematica ◽

10.36285/tm.53 ◽

2021 ◽

Author(s):

James Anderson ◽

Jan Bergstra

Keyword(s):

Real Numbers ◽

Integral Calculus ◽

Arithmetical Functions ◽

First Order ◽

Advantages And Disadvantages ◽

Definition Of ◽

Type 3 ◽

Order Predicate Calculus

We review the exposition of division by zero and the definition of total arithmetical functions in ``Introduction to Logic" by Patrick Suppes, 1957, and provide a hyperlink to the archived text. This book is a pedagogical introduction to first-order predicate calculus with logical, mathematical, physical and philosophical examples, some presented in exercises. It is notable for (i) presenting division by zero as a problem worthy of contemplation, (ii) considering five totalisations of real arithmetic, and (iii) making the observation that each of these solutions to ``the problem of division by zero" has both advantages and disadvantages -- none of the proposals being fully satisfactory. We classify totalisations by the number of non-real symbols they introduce, called their Extension Type. We compare Suppes' proposals for division by zero to more recent proposals. We find that all totalisations of Extension Type 0 are arbitrary, hence all non-arbitrary totalisations are of Extension Type at least 1. Totalisations of the differential and integral calculus have Extension Type at least 2. In particular, Meadows have Extension Type 1, Wheels have Extension Type 2, and Transreal numbers have Extension Type 3. It appears that Suppes was the modern originator of the idea that all real numbers divided by zero are equal to zero. This has Extension Type 0 and is, therefore, arbitrary.

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Proposal of Venous Drainage–Based Classification System for Carotid Cavernous Fistulae With Validity Assessment in a Multicenter Cohort

Neurosurgery ◽

10.1227/neu.0000000000000829 ◽

2015 ◽

Vol 77 (3) ◽

pp. 380-385 ◽

Cited By ~ 13

Author(s):

Ajith J. Thomas ◽

Michelle Chua ◽

Matthew Fusco ◽

Christopher S. Ogilvy ◽

R. Shane Tubbs ◽

...

Keyword(s):

Endovascular Treatment ◽

Classification System ◽

Internal Carotid ◽

Treatment Approach ◽

Venous Drainage ◽

Validity Assessment ◽

Drainage Channels ◽

Type 3

Abstract BACKGROUND: Carotid cavernous fistulae (CCFs) are most commonly classified based on arterial supply. Symptomatology and treatment approach, however, are largely influenced by venous drainage. OBJECTIVE: To propose an updated classification system using venous drainage. METHODS: CCFs with posterior/inferior drainage only, posterior/inferior and anterior drainage, anterior drainage only, and retrograde drainage into cortical veins with/without other drainage channels were designated as types 1, 2, 3, and 4, respectively. CCFs involving a direct connection between the internal carotid artery and cavernous sinus were designated as type 5. This system was retrospectively applied to 29 CCF patients. RESULTS: Our proposed classification was significantly associated with symptomatology (P.001). Type 2 was significantly associated with coexisting ocular/orbital and cavernous symptoms only (P.001), type 3 with ocular/orbital symptoms only (P.01), and type 4 demonstrated cortical symptoms with/without ocular/orbital and cavernous symptoms (P.01), respectively. There was a significant association of our classification system with the endovascular treatment approach (P.001). Types 1 and 2 were significantly associated with endovascular treatment through the inferior petrosal sinus (P.01). Type 3 was significantly associated with endovascular treatment through the ophthalmic vein (P.01) and type 5 with transarterial approach (P.01), respectively. Types 2 (27.6%) and 3 (34.5%) were most prevalent in this series, whereas type 1 was rare (6.9%), suggesting that some degree of thrombosis is present, with implications for spontaneous resolution. Type 2 CCFs demonstrated a trend toward partial resolution after endovascular treatment (P = .07). CONCLUSION: Our proposed classification system is easily applicable in clinical practice and demonstrates correlation with symptomatology, treatment approach, and outcome.

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Comparison of Surgical Resection and Stereotactic Radiosurgery in the Initial Treatment of Brain Metastasis

Stereotactic and Functional Neurosurgery ◽

10.1159/000509319 ◽

2020 ◽

Vol 98 (6) ◽

pp. 404-415

Author(s):

Zhen Liu ◽

Shuting He ◽

Liang Li

Keyword(s):

Brain Metastasis ◽

Cohort Studies ◽

Stereotactic Radiosurgery ◽

Surgical Resection ◽

Initial Treatment ◽

English Language ◽

Meta Analysis ◽

Cochrane Library ◽

Advantages And Disadvantages ◽

Subgroup Analyses

Background: Brain metastasis (BM) is the most common brain malignancy and a common cause of death in cancer patients. However, the relative outcome-related advantages and disadvantages of surgical resection (SR) and stereotactic radiosurgery (SRS) in the initial treatment of BM are controversial. Method: We systematically reviewed the English language literature up to March 2020 to compare the efficacy of SR and SRS in the initial treatment of BM. We identified cohort studies from the Cochrane Library, PubMed, and EMBASE databases and conducted a meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Twenty cohort studies involving 1,809 patients were included. Local control did not significantly differ between the SR and SRS groups overall (hazard ratio [HR] 1.02, 95% confidence interval (CI) 0.64–1.64, p = 0.92; I2 = 54%, p = 0.03) or in subgroup analyses of SR plus SRS vs. SRS alone, SR plus whole brain radiation therapy (WBRT) versus SRS plus WBRT, or SR plus WBRT versus SRS alone. Distant intracranial control did not significantly differ between the SR and SRS groups overall (HR 0.78, 95% CI 0.38–1.60, p = 0.49; I2 = 61%, p = 0.03) or in subgroup analyses of SR plus SRS versus SRS alone or SR plus WBRT versus SRS alone. In addition, overall survival (OS) did not significantly differ in the SR and SRS groups (HR 0.91, 95% CI 0.65–1.27, p = 0.57; I2 = 47%, p = 0.09) or in subgroup analyses of SR plus SRS versus SRS alone, SR plus WBRT versus SRS alone or SR plus WBRT versus SRS plus WBRT. Conclusion: Initial treatment of BM with SRS may offer comparable local and distant intracranial control to SR in patients with single or solitary BM. OS did not significantly differ between the SR and SRS groups in people with single or solitary BM.

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Cheek Dimpleplasty: A Review of the Literature

The American Journal of Cosmetic Surgery ◽

10.1177/0748806819883085 ◽

2019 ◽

Vol 37 (2) ◽

pp. 91-96 ◽

Cited By ~ 1

Author(s):

Jude L. Opoku-Agyeman ◽

Jamee E. Simone ◽

David V. Matera ◽

Amir B. Behnam

Keyword(s):

English Language ◽

Facial Animation ◽

Cochrane Library ◽

Review Of The Literature ◽

Regional Anatomy ◽

Buccinator Muscle ◽

Basic Tenet ◽

The Face ◽

The Ideal

Dimpleplasty is the surgical creation of dimples on the face for aesthetic purposes. Dimples have been associated with a sign of beauty and even good fortune in some cultures and have also found themselves in Western cultures. Since the first described procedure of cheek dimple creation in 1962, there have been multiple studies on the topic. The aim of this article is to review the literature on the anatomy, creation, postoperative care, and complications associated with cheek dimpleplasty. The authors performed a literature review that focused on cheek dimpleplasty. EMBASE, Cochrane Library, Ovid Medicine, MEDLINE, Google Scholar, and PubMed databases were searched from its inception to July 2019. Peer-reviewed articles published in the English language were included. Our search in the various databases yielded multiple publications. There were different described techniques published on the determination of the ideal site for a cheek dimple. There were also multiple procedures described for the creation of cheek dimples. The basic tenet of cheek dimple creation is to create an adhesion between the dermis and buccinator muscle to create a dynamic dimple which is present on facial animation. Multiple procedures have been reported with few reported complications. Patient satisfaction is dependent on appropriate determination of the site and morphology of the dimple. Most of the complications associated with cheek dimple creation are minor, easily managed, and avoided by understanding the regional anatomy and attention to meticulous surgical technique.

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A novel classification for medial malleolar fracture based on the 3-D reconstruction CT

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02688-9 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Fangke Hu ◽

Guoyun Bu ◽

Jun Liang ◽

Haijing Huang ◽

Jinquan He

Keyword(s):

Medial Malleolus ◽

The Novel ◽

New Classification ◽

Surgical Decision ◽

Posterior Malleolus ◽

Type 3 ◽

Surgical Decision Making

Abstract Background Fracture of the medial malleolus is one of the most frequent injuries treated surgically; however, the classification of the fracture has not attracted much attention and a good classification system is still lacking. Methods Consecutive cases of medial malleolus fractures were prospectively enrolled. Based on the 3-D reconstruction CT morphology and centered on the posterior colliculus of the medial malleolus, we classified the fractures into 4 types: type 1 with no involvement of the posterior colliculus, type 2 with partial involvement of posterior colliculus, type 3 with the entire involvement of posterior colliculus, and type 4 with the fracture line 4 vertically extended from the intercollicular groove to the comminuted fracture of the posterior malleolus. Statistical analyses were performed to evaluate the clinical significance of the classification. Results There were 273 cases prospectively enrolled. The distribution of the cases was type 1 of 12.1%, type 2 of 41.0%, type 3 of 30.0%, and type 4 of 16.8%. Statistics showed that the new classification had significant associations but did not totally depend on the classical ankle fracture classifications. Results showed that the new classification had implications in the severity of ankle fractures. From type 1 to type 4, the ankle joint was more and more unstable. Furthermore, comminuted medial malleolar fractures could be subdivided, and the new classification could provide useful information for surgical decision-making. Conclusions The novel classification was a useful system to describe the 3-D geometry of the fractured medial malleolus.

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