Periorbital lipogranuloma after facial injection of autologous fat: A retrospective study of 18 cases

2020 ◽  
pp. 112067212093857
Author(s):  
Xiuting Yu ◽  
Huan Yan ◽  
Lihua Xiao ◽  
Yan Hei
Keyword(s):  
Case Series ◽  
Surgical Excision ◽  
Clinical History ◽  
Retrospective Case ◽  
Palpable Mass ◽  
Autologous Fat ◽  
Radiologic Findings ◽  
Eyelid Swelling ◽  
Facial Augmentation ◽  
Eye Symptoms

Objective: To investigate the clinical features of patients who develop periorbital lipogranuloma after injection of autologous fat. Methods: This retrospective case series included 18 patients who developed a periorbital mass or swelling after undergoing injection of autologous fat for facial augmentation. The patients’ medical records were reviewed for clinical history, radiologic findings, and treatment outcomes. Results: All patients were women aged 24 to 50 years (mean, 31.6 years). Five patients (27.8%) involved both orbits. Presenting eye symptoms were a palpable mass (61.1%), eyelid swelling (44.4%), and ptosis (16.7%). The interval between the final injection and onset of eye symptoms ranged from 1 to 36 months (mean, 11.5 months). Thirteen patients underwent radiologic imaging. Fifteen patients received only one injection of autologous fat and three received two injections with the cryopreserved fat used in the second injection. Surgical excision was performed in 12 patients to remove the mass and identify the pathologic abnormalities. No recurrence was found during 1 year of follow-up. Two of the six patients who had refused treatment showed spontaneous resolution at the 6-month visit. Conclusion: Periorbital lipogranuloma after facial injection of autologous fat should be considered as a specific orbital disease entity for which MRI is an effective examination method. Surgery is warranted for this condition when conservative treatment is ineffective.

Ewing’s Sarcoma of the Hand

2008 ◽  
Vol 34 (1) ◽  
pp. 35-39 ◽  
Author(s):  
O. A. ANAKWENZE ◽  
W. L. PARKER ◽  
L. E. WOLD ◽  
K. K AMRAMI ◽  
P. C. AMADIO
Keyword(s):  
Radiation Therapy ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Case Series ◽  
Surgical Excision ◽  
Case Review ◽  
Retrospective Case ◽  
Postoperative Radiation Therapy ◽  
Definitive Surgery

A retrospective case review was carried out to report the outcomes in a contemporary case series of Ewing’s sarcoma originating in the hand. We identified five patients treated since 1995. All five had wide surgical excision, one by ray amputation. All were treated with chemotherapy. Four patients also received radiation therapy, two to treat metastases and two as an adjunct to local excision. There were no local recurrences. Two patients developed metastases. Both died of their disease. Neither of these two patients had received local postoperative radiation therapy; one did not receive chemotherapy before definitive surgery. The other three patients were alive and free of disease at last follow-up, 4 to 12 years after initial presentation.

Computed tomography–guided epidural patching of postoperative cerebrospinal fluid leaks

2014 ◽  
Vol 21 (5) ◽  
pp. 805-810 ◽  
Author(s):  
Frank Mihlon ◽  
Peter G. Kranz ◽  
Andreia Roxana Gafton ◽  
Linda Gray
Keyword(s):  
Cerebrospinal Fluid ◽  
Spinal Surgery ◽  
Case Series ◽  
Clinical History ◽  
Percutaneous Intervention ◽  
Dural Defect ◽  
Retrospective Case ◽  
Ct Guided ◽  
Cerebrospinal Fluid Leaks ◽  
Dural Defects

Object Cerebrospinal fluid leaks due to unrecognized durotomy during spinal surgery are often managed with a second surgery for dural closure. CT-guided percutaneous patching targeted to the dural defect offers an alternative to surgery since it can be performed in a minimally invasive fashion without the need for general anesthesia. This case series describes the authors' experience using targeted CT-guided percutaneous patching to repair incidental durotomies incurred during spinal surgery. Methods This investigation is a retrospective case series involving patients who underwent CT-guided percutaneous patching of surgical incidental durotomies and were referred between January 2007 and June 2013. Their presenting clinical history, myelographic findings, and clinical outcomes, including the need for eventual surgical duraplasty, were reviewed. Results Nine cases were identified, including 7 durotomies incurred during lumbar discectomy, one due to a medial transpedicular screw breach, and one incurred during vertebrectomy for spinal osteosarcoma. All patients who had favorable outcomes with percutaneous intervention alone had 2 common features: dural defect of 4 mm or smaller and absence of a pseudomeningocele. Patients with CSF leaks complicated by pseudomeningocele and those with a dural defect of 6 mm or more all required eventual surgical management. Conclusions The authors' results suggest that findings on CT myelography may help predict which patients with postsurgical durotomy can be treated with percutaneous intervention. In particular, CT-guided patching may be more likely to be successful in those patients with dural defects of less than 5 mm and without pseudomeningocele. In patients with larger dural defects or pseudomeningoceles, percutaneous blood patching alone is unlikely to be successful.

scholarly journals The Association between Preoperative Dry Eye Symptoms and Postoperative Discomfort in Patients Underwent Photorefractive Keratectomy

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Gilad Rabina ◽  
Ingibjorg Iris Boguslavsky ◽  
Michael Mimouni ◽  
Igor Kaiserman
Keyword(s):  
Postoperative Pain ◽  
Dry Eye ◽  
Subjective Evaluation ◽  
Case Series ◽  
Photorefractive Keratectomy ◽  
Ocular Surface Disease Index ◽  
Retrospective Case ◽  
Significant Difference ◽  
Eye Symptoms ◽  
Dry Eye Symptoms

Purpose. To investigate the association between preoperative dry eye symptoms on postoperative pain and discomfort after photorefractive keratectomy (PRK). Methods. A retrospective case series of 151 consecutive patients, who underwent myopic PRK in both eyes between 5/2016 and 5/2017. Patients with positive dry eye disease (DED) signs on clinical examination or with known DED were excluded. Patients underwent a subjective evaluation for dry eye symptoms using ocular surface disease index (OSDI) and modified standard patient evaluation of eye dryness (SPEED) questionnaires. One day postoperatively, the patients were evaluated again by a questionnaire of pain, discomfort, photophobia, foreign body sensation, satisfaction with vision, and frequency of usage of anesthetic drops. Results. Fifty-two patients had any preoperative dry eye symptoms (OSDI score > 0) compared to 99 nonsymptomatic patients (OSDI score of 0). Postoperatively, the symptomatic dry eye patients suffered significantly more pain than the nondry eye patients (p=0.02). Thirteen patients had a cumulated modified SPEED score >4 (moderate to severe) in comparison to 138 patients with score of 0–4 (non to mild). Patients with moderate to severe preoperative symptoms suffered more pain (p=0.006), photophobia (p=0.005), and epiphora (p=0.03). No statistically significant difference was seen in postoperative subjective visual quality (p=0.82) between the two groups. Conclusion. Preoperative dry eye symptoms may be associated with postoperative pain, epiphora, and photophobia and thus influence negatively on patient satisfaction with this procedure.

Pharyngeal Pouch and Cleft Remnants in the Dog and Cat: A Case Series and Review

2012 ◽  
Vol 48 (2) ◽  
pp. 105-112 ◽  
Author(s):  
Laura L. Nelson ◽  
Joana C. Coelho ◽  
Kristy Mietelka ◽  
Ingeborg M. Langohr
Keyword(s):  
Salivary Gland ◽  
Case Series ◽  
Surgical Excision ◽  
Submandibular Salivary Gland ◽  
Small Animals ◽  
Ciliated Epithelium ◽  
Cystic Lesions ◽  
Pharyngeal Pouch ◽  
Retrospective Case ◽  
Pharyngeal Apparatus

Remnants of the pharyngeal apparatus can (rarely) form cysts. This retrospective case series describes clinical and histologic findings of such lesions. Clinical and histology databases were searched for cases of pharyngeal remnants. Eight patients were diagnosed with cysts located subcutaneously in the head and neck, adjacent to the submandibular salivary gland, near the thyroid, and in the mediastinum. Cyst linings included ciliated epithelium, and surgical excision was curative. Knowledge of pharyngeal development is useful for their characterization. Clinicians should consider pharyngeal remnants as differentials for cystic lesions in small animals.

Loss of Reflex Tearing: An Expected Consequence of Juvenile Nasopharyngeal Angiofibroma

2005 ◽  
Vol 133 (4) ◽  
pp. 605-610 ◽  
Author(s):  
Alexander T. Hillel ◽  
Rebecca C. Metzinger ◽  
Andrew J. Nemechek ◽  
Daniel W. Nuss
Keyword(s):  
Surgical Treatment ◽  
Hospital Setting ◽  
Case Series ◽  
Surgical Excision ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Retrospective Case ◽  
Nasopharyngeal Angiofibroma ◽  
Complete Surgical Excision ◽  
Major Teaching Hospital ◽  
Pterygopalatine Ganglion

OBJECTIVE: To report the loss of reflex tearing after surgical treatment of juvenile nasopharyngeal angiofibroma (JNA). STUDY DESIGN AND SETTING: A retrospective case series of 8 patients with surgical extirpation of JNA from 1995 to 2003 in a major teaching hospital setting was studied for symptomatic xerophthalmia. RESULTS: One patient was lost to follow-up. Four of the remaining 7 patients reported a dry ipsilateral eye after surgical treatment of JNA. CONCLUSION: The location of the pterygopalatine ganglion and its associated fibers in the pterygopalatine fossa is directly adjacent to the location of origin of JNA. Lacrimal innervation passes through the pterygopalatine ganglion. Given the extensive nature of advanced JNA and mandate for complete surgical excision, lacrimal dysfunction should be considered an expected consequence of surgery. SIGNIFICANCE: The loss of reflex tearing has not been reported as a consequence of JNA or its surgical treatment. EBM Rating: C.

Systemic neoadjuvant chemotherapy in non-resectable invasive squamous cell carcinoma of ocular surface

2021 ◽  
pp. 112067212110143
Author(s):  
Rachna Meel ◽  
Rebika Dhiman ◽  
Seema Kashyap ◽  
Sahil Agrawal ◽  
Neelam Pushker ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Ocular Surface ◽  
Tumor Imaging ◽  
Case Series ◽  
Surgical Excision ◽  
Response To Treatment ◽  
High Morbidity ◽  
Complete Regression ◽  
Invasive Squamous Cell Carcinoma ◽  
Retrospective Case

Background/objectives: The conventional modality for management of advanced invasive ocular surface squamous neoplasia (OSSN) (AJCC grade T4 and T3 with fornicial involvement) is surgical excision which is not only challenging in terms of ability to achieve tumor free margins and tissue reconstruction but also has high morbidity. We describe the use of systemic neoadjuvant chemotherapy (NAC) in cases of advanced invasive OSSN. Subjects/methods: This is a retrospective case series. Five cases of histopathologically proven advanced OSSN that were challenging to manage with surgical excision or required exenteration were treated with NAC. Demographic details, previous treatment history, location and extent of tumor, imaging findings, number of cycles and duration of NAC, response to treatment, and final outcome on follow-up were noted. Results: A remarkable response to NAC was seen in 4/5(80%) cases. Complete regression was seen in 2/5, partial regression in 2/5, and no response in 1/5 cases. In 75% (3/4) cases who showed response to NAC, minimal or no surgery was required. Exenteration was avoided in 2/3 cases with orbital extension. Conclusion: NAC appears to be an exciting option for management of surgically challenging cases of invasive OSSN and may be helpful in avoiding orbital exenteration. However, more studies are required to explore this treatment option.

scholarly journals Breast Silicone Gel Implants versus Autologous Fat Grafting: Biomaterials and Bioactive Materials in Comparison

2021 ◽  
Vol 10 (15) ◽  
pp. 3310
Author(s):  
Pietro Gentile
Keyword(s):  
Pectus Excavatum ◽  
Case Series ◽  
Fat Grafting ◽  
Autologous Fat Grafting ◽  
Retrospective Case ◽  
Bioactive Materials ◽  
Autologous Fat ◽  
Areola Complex ◽  
Low Toxicity ◽  
Chest Deformities

In the last 20 years, surgical procedures in breast remodeling during mammoplasty have been deeply modified with a gradual shifting from an invasive intervention using definitive implants (DIs) to a more conservative autologous fat grafting (AFG). AFG has been used for many years as bioactive material through the Lipofilling technique and as a bioactive scaffold when it was enriched with adipose-derived stem cells (ASCs), while DIs have been considered physiologically inert biomaterials with low toxicity. The paper aimed to compare the breast remodeling results obtained in the DI group (55 patients) for hypoplasia correction with those of the ASC-enhanced AFG group (50 patients), also analyzing the influence of breast and chest deformities (tuberous breast, volume, and nipple–areola complex asymmetry, pectus excavatum and carinatum) in the cosmetic outcome. A retrospective, case-control study was conducted. The pre-operative analysis was performed with an accurate clinical evaluation, a photographic assessment, and an instrumental evaluation based on magnetic resonance imaging, mammography, and ultrasound. Of patients treated with DIs 89% (n = 49) showed excellent cosmetic results after 1 year compared with the patients treated with AFG, who showed the same results in 64% (n = 32) of cases. The naturalness of the results in the AFG group was higher than that in the DI group (p < 0.0001 vs. DI group). DIs and AFG were safe and effective in this case series treated. The AFG group showed more natural results, allowing the treatment of patients with pectus excavatum, while DIs showed the more evident and lasting result.

The Effectiveness of Nortriptyline and Tolerability of Side Effects in Neurogenic Cough Patients

2020 ◽  
pp. 000348942097023
Author(s):  
Sungjin A. Song ◽  
Kanittha Choksawad ◽  
Ramon A. Franco
Keyword(s):  
Side Effects ◽  
Case Series ◽  
Clinical History ◽  
Demographic Information ◽  
Retrospective Case ◽  
Exclusion Criteria ◽  
Level Of Evidence ◽  
Medication Dosage ◽  
Lost To Follow Up

Objective: To determine the effectiveness of nortriptyline and tolerability of side effects in the treatment of neurogenic cough. Secondary goal is to evaluate the association between laryngeal asymmetry and clinical response to nortriptyline. Study Design: Retrospective case series. Materials and Methods: Consecutive patients diagnosed with neurogenic cough at a quaternary care specialty hospital from 2001 to 2020 were identified. Subjects <18 years old, not treated with nortriptyline, did not have a nasolaryngoscopic examination and were lost to follow-up were excluded. Charts were reviewed for demographic information, clinical history, nasolaryngoscopic findings, medication dosage, side effects, and follow-up time. Results: Forty-two patients met inclusion and exclusion criteria, 7 males and 35 females with an average age of 56.5 (±13.1) years. There were 26/36 (72.2%) responders and 10/36 (27.8%) non-responders; 6 patients stopped nortriptyline due to side effects and were not included in the response comparison. Laryngeal asymmetry was present in 36/42 (85.7%) patients. No factors related to laryngeal asymmetry were significantly different between responders and non-responders. Medication tolerance was observed in 3/42 (7.1%) patients. Side effects were reported in 16/42 (38.1%) patients. The most common side effects were sedation 9/42 (21.4%) and xerostomia 3/42 (7.1%). Conclusion: Nortriptyline is effective for treating neurogenic cough with 72% of patients reporting improvement in cough. Evidence of laryngeal asymmetry was not associated with better treatment response. Although 38% experienced side effects, the majority of patients continued nortriptyline despite side effects. Level of Evidence: 4

Safety and Efficacy Concerns of Autologous Fat Grafting for Velopharyngeal Insufficiency

2017 ◽  
Vol 55 (3) ◽  
pp. 383-388 ◽  
Author(s):  
Yun S. Phua ◽  
Mark J. Edmondson ◽  
Rachel J. Kerr ◽  
Kirstie A. Macgill ◽  
Rodrigo P. Teixeira ◽  
...  
Keyword(s):  
Revisional Surgery ◽  
Case Series ◽  
Fat Grafting ◽  
Velopharyngeal Insufficiency ◽  
Autologous Fat Grafting ◽  
Retrospective Case ◽  
Safety And Efficacy ◽  
Autologous Fat ◽  
Obstructive Sleep ◽  
Speech Assessment

Objective: Autologous fat grafting of the velopharynx has been well described for the treatment of velopharyngeal insufficiency (VPI), with most studies purporting it as a technique with low morbidity useful in the treatment of mild VPI. Prompted by 3 cases of obstructive sleep apnea (OSA) following fat grafting of the velopharynx, we undertook a review of the outcomes of this procedure at our unit. Design: Retrospective case series. Participants: All patients who underwent autologous fat grafting for VPI at the Royal Children’s Hospital Melbourne. Main Outcome Measures: Preoperative nasendoscopy findings, perceptual speech assessment results, and rates of revisional surgery and complications. Results: Twenty-eight patients were included in the study. Three patients (11%) developed severe OSA requiring removal of the grafted fat. In a subanalysis of cleft patients, there was a reported improvement in hypernasality in 63% though only 25% had complete resolution of their hypernasality. Patients who had an improvement in speech were more likely to have a velopharyngeal gap of less than 0.5 cm2 on preoperative nasendoscopy. All 3 patients who developed OSA had syndromes associated with hypotonia. Conclusions: This study raises serious concerns over the safety and efficacy of fat grafting for VPI. Overall, there was a relatively high complication rate with generally poor speech results in our series of patients. Stringent criteria should be used to select candidates for fat grafting, namely, a velopharyngeal gap less than 0.5 cm2 and the absence of a syndrome associated with hypotonia.

Delayed metastasis in patients with intraocular retinoblastoma: A review of three cases

2020 ◽  
pp. 112067212094628
Author(s):  
Vijitha S Vempuluru ◽  
Saumya Jakati ◽  
Swathi Kaliki
Keyword(s):  
Metastatic Disease ◽  
Tumor Regression ◽  
External Beam Radiotherapy ◽  
Case Series ◽  
Surgical Excision ◽  
Primary Treatment ◽  
Retrospective Case ◽  
Temporal Fossa ◽  
Intravitreal Chemotherapy

Purpose: To discuss the clinical presentation, management, and outcome of delayed metastasis in retinoblastoma (RB). Methods: Retrospective case series of three patients. Results: Mean age at diagnosis of RB was 29 months (median, 28 months; range, 11–48 months). All were males with non-familial bilateral intraocular RB. Primary treatment for RB included intravenous chemotherapy in all three cases. Secondary treatment included transpupillary thermotherapy/cryotherapy ( n = 6 eyes), periocular chemotherapy ( n = 2 eyes), intravitreal chemotherapy ( n = 1 eye), intra-arterial chemotherapy ( n = 1 eye), external beam radiotherapy (EBRT; n = 2 eyes), and enucleation ( n = 2 eyes). Primary tumor regression was achieved in all cases and remained status quo at the time of diagnosis of distant metastasis. Two patients developed bone metastasis (ulna; tibia) and one developed soft tissue metastasis (temporal fossa) over a mean follow-up period of 6 years (median, 7 years; range, 5–8 years) from diagnosis of RB. Mean age of detection of metastatic disease was 8 years (median, 8 years; range, 7–9 years). All the lesions were solitary and the diagnosis of metastatic retinoblastoma was confirmed by tissue biopsy. Metastatic disease was treated with surgical excision ( n = 1), chemotherapy ( n = 2), and EBRT ( n = 2). All patients are alive, with two patients free of disease over a mean follow-up period of 23 months (median, 23 months; range, 12–33 months); and 1 in remission 7 months after completion of EBRT. Conclusion: Long-term follow-up of RB cases is mandatory. In spite of intraocular tumor regression, metastasis can still occur many years after treatment of RB.

Sign in / Sign up

Export Citation Format

Share Document