Craniofacial Cleft: A Case of Tessier 10 Cleft With a Novel Method to Repair Large Bilateral Colobomas

2019 ◽  
Vol 56 (10) ◽  
pp. 1377-1380
Author(s):  
Joshua M. Barnett ◽  
John H. Y. Pang ◽  
Sean Herman ◽  
Jonathan Lee ◽  
S. Tonya Stefko ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Case ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Upper Eyelid ◽  
Eyelid Closure ◽  
Large Rotation ◽  
Rotation Flap ◽  
Novel Method ◽  
Full Thickness Excision

Objective: To describe a reliable method utilizing large, rotation flaps to reconstruct a number 10 Tessier cleft. Design: This is a descriptive clinical case report. Setting: Pediatric teaching hospital affiliated with a university. Patients, Participants: One participant in this clinical case report. Interventions: Full-thickness excision of the clefted eyelid, brow, and forehead tissue was performed bilaterally to develop medial and lateral eyebrow and forehead flaps. Right: the forehead/brow flap was rotated caudally to reapproximate the eyebrow and an eyelid rotation flap was also used to reapproximate the lid margin. Left: forehead/brow rotation flap allowed realignment of the eyebrow and a series of Z-plasties were used in the eyelid to reapproximate the lid margin and to lengthen the eyelid. Main Outcome Measure(s): Develop and construct a reliable reconstruction with full-eyelid closure and minimal donor site morbidity. Results: Complete eyelid closure bilaterally was achieved intraoperatively, and was maintained at 6-month follow-up with no evidence of ocular pathology. Conclusions: Large, bilateral upper eyelid colobomas require repair to prevent blindness. Although free tarsomarginal grafts and lid-sharing procedures have been described, we demonstrate that large rotation flaps designed along the cleft margin can provide a reliable reconstruction and minimize donor-site morbidity.

Fifth toe Fillet Flap for Wound Coverage of Non-Healing Ulcer of the Foot: Surgical Technique and a Case Report

2020 ◽  
Vol 9 (2) ◽  
pp. 7-10
Author(s):  
Sunny Chaudhary ◽  
Shivakumar A Bali ◽  
Arvind Singh ◽  
R K Siddharth
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Functional Limitations ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Healing Ulcer ◽  
Wound Coverage ◽  
Fillet Flap ◽  
Plantar Aspect ◽  
Partial Amputation

Fillet flap is one of the options in the treatment of diabetic non-healing ulcers. The advantages of the fillet flap include the absence of donor site morbidity, excellent durability and preventing the need for more proximal amputation. A 56-year-old farmer presented to the out-patient department with complaints of a non-healing ulcer on the sole of the right foot for the past 7 months which was managed conservatively. A fifth ray partial amputation and a rotational flap of the redundant fifth finger for wound coverage were done. The wound healing was uneventful and the sutures were removed after two weeks. At the latest follow-up of 2 years, the patient was able to walk independently without pain and without any functional limitations. This case report describes the surgical technique of the lateral lesser toe fillet flap for wound closure on the plantar aspect of foot as an alternative to secondary healing or more proximal amputations.

Functional reconstruction of subtotal glossectomy defects with radial forearm free flap: case report and review of literature

Folia Medica ◽  
2012 ◽  
Vol 54 (2) ◽  
pp. 60-65 ◽  
Author(s):  
Dimitar D. Pazardzhikliev ◽  
Christo D. Shipkov ◽  
Ilya P. Yovchev ◽  
Regina H. Khater ◽  
Ivailo S. Kamishev
Keyword(s):  
Case Report ◽  
Free Flap ◽  
Donor Site ◽  
Perforator Flap ◽  
Functional Results ◽  
Donor Site Morbidity ◽  
Oral Feeding ◽  
Tram Flap ◽  
Radial Forearm Free Flap ◽  
Radial Forearm

ABSTRACT Adequate reconstruction of defects that are consequences of glossectomy is of primary importance for achieving satisfactory functional results and improving the quality of life. AIM: The aim of this study was to report a case of free flap reconstruction of a subtotal glossectomy defect and discuss it in relation to other available methods. CASE REPORT: A 48- year-old woman was operated on for a T4N0M0 squamous cell carcinoma of the tongue. A subtotal glossectomy via mandibular swing procedure with bilateral supraomohyoid neck dissection and reconstruction with a radial forearm free flap (RFFF) was performed. Surgery was followed by adjuvant radiotherapy. RESULTS: The post-operative period was uneventful. The patient resumed intelligible speech evaluated as “excellent” and oral feeding. The donor site morbidity was acceptable. Present reconstructive options of the tongue include two categories: to maintain mobility or to provide bulk. In glossectomy with 30 to 50 percent preservation of the original musculature, maintaining the mobility of the remaining tongue by a thin, pliable flap is preferred. This can be achieved by infrahyoid myofascial, medial sural artery perforator flap, RFFF, anterolateral thigh and ulnar forearm flap. When the post-resectional volume is less than 30 percent of the original tongue, the reconstruction shifts to restoration of bulk to facilitate swallowing by providing contact of the neotongue with the palate. Flaps providing bulk include the free TRAM flap, latissimus dorsi myocutaneous free flap, pectoralis major musculocutaneous flap and trapezius island flap. CONCLUSION: Surgical treatment of advanced tongue cancer requires adequate reconstruction with restoration of speech, swallowing and oral feeding. Free tissue transfer seems to achieve superior functional results with acceptable donor site morbidity when indicated.

scholarly journals The First Stage of Acquired Syndactyly Reconstruction - A Rare Case Report

2022 ◽  
Vol 12 (1) ◽  
pp. 87-91
Author(s):  
Lucretya Yeniwati Tanuwijaya ◽  
Agus Roy Rusly Hariantana Hamid ◽  
I Gusti Putu Hendra Sanjaya
Keyword(s):  
Case Report ◽  
Skin Graft ◽  
Skin Flap ◽  
Donor Site ◽  
Surgical Techniques ◽  
Operation Time ◽  
Donor Site Morbidity ◽  
Reconstruction Procedure ◽  
Local Skin ◽  
And Function

Background: Acquired syndactyly is a very rare disorder on the interdigital area. Syndactyly with only soft tissue involvement can be a sequela of trauma, such as burn, inflammation or infection in the interdigital area, resulting in bony fusion following crush injury. Case Report: An 8-year-old boy came to our department with fusion from the base to the tip of the first to fourth right toes since the accidental step on burnt plastic 5 years ago. He complained of a poor appearance and discomfort when walking. Then we performed zigzag incision for first to second toes and third to fourth toes. Skin graft closure was performed to cover the defect on third to fourth toes. The second reconstruction surgery will be scheduled 6 months later. Discussion: The surgical techniques for foot syndactyly were derived from those for hand syndactyly, which are to separate the digital fusion by creating local skin flap. Additionally, skin graft might be necessary when recent surgeons avoid the use of skin graft for open treatment, primary closure by defatting, or intricate local flaps. These can shorten the operation time and minimize donor site morbidity. However, surgeons should consider the free tension closure of the wound by combining the skin graft after the flap. Conclusion: Reconstruction procedure for foot syndactyly aims to improve the appearance and function of the toes as well as to avoid progressive deformity through development. The skin graft addition in combination of skin flap shows promising outcome. Key words: acquired syndactyly, syndactyly reconstruction, zigzag flap, skin graft.

scholarly journals Case Report

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. NP38-NP40 ◽  
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.

scholarly journals Treatment of chronic bronchopleural fistula and recurrent empyema using a latissimus dorsi myocutaneous flap: a case report and literature review

2021 ◽  
Vol 48 (5) ◽  
pp. 494-497
Author(s):  
Byungkwon Kang ◽  
Yujin Myung
Keyword(s):  
Case Report ◽  
Latissimus Dorsi ◽  
Pulmonary Resection ◽  
Myocutaneous Flap ◽  
Treatment Options ◽  
Donor Site ◽  
Bronchopleural Fistula ◽  
Donor Site Morbidity ◽  
Flap Transfer ◽  
Latissimus Dorsi Myocutaneous Flap

Bronchopleural fistula is a severe complication with a high mortality rate that occurs after pulmonary resection. Several treatment options have been suggested; however, it is a challenge to treat this condition without recurrence or other complications. In this case report, we describe the successful performance of a pedicled latissimus dorsi myocutaneous flap transfer, with no recurrence or donor site morbidity.

Fibular-Lengthening Osteotomy to Correct a Malunited Ankle Fracture Using Fresh-Frozen Femoral Head Allograft

2017 ◽  
Vol 107 (4) ◽  
pp. 318-323 ◽  
Author(s):  
Harry J. Visser ◽  
Khawar Malik ◽  
Robert A. Djali
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Medical Literature ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Degenerative Arthritis ◽  
First Case ◽  
Fibular Fracture ◽  
Lengthening Osteotomy ◽  
Fresh Frozen

Malreduction of a distal fibular fracture can lead to degenerative changes in the ankle joint. Previous studies have shown that the selective use of various fibular reconstructive osteotomies may halt the progression of degenerative arthritis by restoring the normal tibiotalar contact area and decreasing the stresses on the articular cartilage. In this case report, we achieved alignment with restoration of the talocrural angle and Shenton's line of the ankle using a transfibular osteotomy and an allogeneic fresh-frozen femoral head graft to fill the resultant defect. The advantage of this procedure is twofold. First, fibular-lengthening procedures may potentially decrease the eventual need for joint-sacrificing procedures such as an arthrodesis or arthroplasty. Second, an allograft allows for larger deficit correction without concern for donor-site morbidity. To our knowledge, this is the first case report using a fresh-frozen femoral head allograft for a fibular-lengthening osteotomy in the podiatric medical literature. Further research with larger patient populations is needed to establish whether fresh-frozen femoral head allograft is a reliable graft option for fibular-lengthening procedures.

scholarly journals Nasoseptal flap for palatal reconstruction after hemi-maxillectomy: case report

2017 ◽  
Vol 132 (1) ◽  
pp. 83-87 ◽  
Author(s):  
M K Alwashahi ◽  
P Battaglia ◽  
M Turri-Zanoni ◽  
P Castelnuovo
Keyword(s):  
Case Report ◽  
Large Scale ◽  
Donor Site ◽  
Stage Iv ◽  
Donor Site Morbidity ◽  
Nasoseptal Flap ◽  
Pedicle Flap ◽  
Maxillary Bone ◽  
Medial Maxillectomy ◽  
Midfacial Degloving

AbstractObjective:Palatal reconstruction following maxillectomy is a surgical challenge, and a nasoseptal flap is a feasible approach. This paper reports the first known successful clinical case of a nasoseptal pedicle flap applied for the reconstruction of maxillary bone following hemi-maxillectomy.Case report:This report describes hemi-maxillectomy in a 60-year-old Italian male diagnosed with stage IV squamous cell carcinoma of the left maxilla. Endoscopic transnasal extended medial maxillectomy was performed, followed by a transoral modified midfacial degloving technique for removal of the maxillary bone. The contralateral nasoseptal pedicle flap was used to reconstruct the defect. The case was followed up prospectively for the assessment of flap reception and healing.Conclusion:The locally accessible nasoseptal flap is a viable alternative for palatal reconstruction; therefore, a second surgical procedure with its associated donor site morbidity can be avoided. Large-scale studies may help in establishing the cosmetic and functional outcomes.

scholarly journals The Use of Split Temporalis Muscle Flap in Maxillofacial Reconstruction

2021 ◽  
Vol 6 ◽  
pp. 247275122110308
Author(s):  
Hisham Marwan ◽  
Caleb Hardman
Keyword(s):  
Case Report ◽  
Postoperative Complication ◽  
Malignant Disease ◽  
Donor Site ◽  
Muscle Flap ◽  
Donor Site Morbidity ◽  
Temporalis Muscle ◽  
Key Points ◽  
Temporalis Muscle Flap

Study Design: Case Report. Objective: The Temporalis muscle (TM) Flap is a reliable, versatile flap with adequate bulk and flexibility. However, temporal hollowing is the most common postoperative complication after harvesting the flap. We describe a surgical modification for harvesting the split TM flap to prevent postoperative temporal hollowing and report 2 cases with up to 18 months of follow-up. Method: This study discusses the posterior ⅔ split temporalis muscle flap in preventing temporal hollowing. We report 2 well-documented cases with up to 18 months of postoperative follow-up. Also, the authors discuss the key points regarding the technique’s indication and limitation. Results: The posterior ⅔ split temporalis muscle flap is reliable in both benign and malignant disease processes. The results demonstrate the flap’s reliability with minimum donor site morbidity. Conclusion: The use of the posterior ⅔ of the TM flap is a viable technique to prevent the flap’s harvest’s temporal hollowing.

Clinical Case Report: Manifestation of Hereditary Neuralgic Amyotrophy in Childhood

2014 ◽  
Vol 45 (S 01) ◽  
Author(s):  
L. Voges ◽  
G. Stettner ◽  
D. Weise ◽  
K. Brockmann ◽  
J. Gärtner ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Case ◽  
Neuralgic Amyotrophy
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