Less is more when treating the nasal ala with superficial radiotherapy

2020 ◽  
Vol 7 (3) ◽  
pp. 66-69
Author(s):  
Lucy M Butcher ◽  
Gerald B Fogarty ◽  
Susan Sinclair ◽  
Hanna Kuchel ◽  
Robert Paver
Keyword(s):  
Functional Outcomes ◽  
Skin Atrophy ◽  
Functional Importance ◽  
Less Is More ◽  
Skin Cancers ◽  
Nasal Ala ◽  
Cosmetic Outcomes ◽  
Standard Fractionation ◽  
Comparative Trials ◽  
Common Malignancy

Skin cancer is the most common malignancy, is increasing in incidence, and occurs most commonly on the head and neck. Cancers of the nasal ala pose therapeutic challenges given the cosmetic and functional importance. Both surgery and radiotherapy (RT) have similar oncological outcomes. RT is tissue-conserving and may have an advantage in cosmetic and functional outcomes, but more comparative trials are needed. RT needs to be delivered well to avoid late effects such as skin atrophy, fibrosis and telangiectasia, which may increase with higher dose per fraction. We describe three cases of self-reported thinning of the nasal ala following definitive mildly hypofractionated superficial radiotherapy (SXRT) of 2.5 Gy per fraction. SXRT to skin cancers of the nasal alar with standard fractionation of at most 2 Gy per fraction may be important in ensuring excellent cosmetic outcomes and patient satisfaction.

scholarly journals A modified Fox pentagon technique performed using a polytetrafluoroethylene sling in frontalis suspension to treat blepharophimosis syndrome

2020 ◽  
Vol 103 (1) ◽  
pp. 003685041989388
Author(s):  
Yuan Wang ◽  
Qian Wu ◽  
Li Li ◽  
Wen Liu ◽  
Cheng Li ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Functional Outcomes ◽  
Average Score ◽  
Palpebral Fissure ◽  
Cosmetic Results ◽  
Frontalis Suspension ◽  
Good Cosmetic ◽  
Cosmetic Outcomes ◽  
The Mean

The purpose of this study was to evaluate the functional and cosmetic outcomes of a new modified Fox pentagon technique performed using polytetrafluoroethylene in frontalis suspension surgery for blepharophimosis syndrome. This retrospective study enrolled 40 patients diagnosed with blepharophimosis syndrome from March 2016 to October 2018. All patients underwent frontalis suspension using a new modified Fox pentagon technique. The functional and cosmetic outcomes were evaluated. After the operation, the mean palpebral fissure height increased from 2.68 to 6.93 in right eyes and from 2.73 to 6.98 in left eyes. The mean MRD1 increased from 0.53 to 3.76 in right eyes and from 0.50 to 3.78 in left eyes. While preoperative to postoperative differences were statistically significant ( p < 0.01), there were no significant differences between right and left eyes either before or after the surgery ( p > 0.01). All patients achieved good cosmetic results with an average score of 0.6. We have experimentally created a modified Fox pentagon technique performed using a polytetrafluoroethylene sling in a frontalis suspension to treat BPES; this approach yielded favorable cosmetic and functional outcomes.

scholarly journals Overview on Topical 5-ALA Photodynamic Therapy Use for Non Melanoma Skin Cancers

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Carmen Cantisani ◽  
Giovanni Paolino ◽  
Valentina Faina ◽  
Federica Frascani ◽  
Franca Cantoresi ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Skin Diseases ◽  
Leisure Activities ◽  
Noninvasive Technique ◽  
Biological Damage ◽  
Skin Cancers ◽  
Wide Range ◽  
Health Significance ◽  
Cure Rates ◽  
Common Malignancy

Ultraviolet radiation (UV) contributes to a variety of skin diseases including inflammation, degenerative aging, and cancer. Historically, humans have been exposed to UV radiation mainly through occupational exposure; recreational UV exposure, however, has increased dramatically in recent years, because of outdoor leisure activities and to purposely tan for cosmetic purposes. Both UVB and UVA radiation have been shown to cause DNA damage and immunosuppression, the important forms of biological damage that lead to NMSC. Nonmelanoma skin cancer (NMSC) is the most common malignancy, whose public health significance is often unrecognized which continues to grow at an alarming rate, becoming an occupational disease. Available treatments alternative to surgery include photodynamic therapy, electrochemotherapy, cryotherapy, ablative lasers, 5-fluorouracil, imiquimod, ingenol mebutate, and diclofenac. Among these, photodynamic therapy is a noninvasive technique with excellent cosmetic outcome and good curative results, when used in initial stages of skin cancers for superficial lesions. It is administered under numerous and significantly varied regimens and there are a wide range of cure rates reported, permitting treatment of large and multiple lesions with excellent cosmetic results. This is an overview of photodynamic applications especially for the treatment of NMSC, with a short focus on daylight modality.

scholarly journals Lateral versus posterior surgical approach for the treatment of supracondylar humeral fractures in children: a systematic review and meta-analysis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 573
Author(s):  
Komang Agung Irianto ◽  
I Putu Gede Pradnyadewa Pradana ◽  
Brigita De Vega
Keyword(s):  
Systematic Review ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Humeral Fracture ◽  
Lateral Approach ◽  
Surgical Approaches ◽  
Eligibility Criteria ◽  
Supracondylar Humeral Fracture ◽  
Fractures In Children ◽  
Cosmetic Outcomes

Background: Supracondylar humeral fracture (SHF) is the most common type of fracture in children. Moreover, lateral and posterior surgical approaches are the most frequently chosen approaches for open reduction surgery in displaced SHF when C-arm is unavailable. However, previous literature showed mixed findings regarding functional and cosmetic outcomes. Currently, no systematic review and meta-analysis has compared these two procedures.  Methods: Our protocol was registered at PROSPERO (registration number CRD42021213763). We conducted a comprehensive electronic database search in MEDLINE, EMBASE, and CENTRAL. Two independent reviewers screened the title and abstract, followed by full-text reading and study selection based on eligibility criteria. The quality of the selected studies was analyzed with the ROBINS-I tool. Meta-analysis was carried out to compare the range of motion (functional outcome) and cosmetic outcome according to Flynn’s criteria. This systematic review was conducted based on PRISMA and Cochrane handbook guidelines.  Results: Our initial search yielded 163 studies, from which we included five comparative studies comprising 231 children in the qualitative and quantitative analysis. The lateral approach was more likely to result in excellent (OR 1.69, 95% CI [0.97-2.93]) and good (OR 1.12, 95% CI [0.61-2.04]) functional outcomes and less likely to result in fair (OR 0.84, 95% CI [0.34-2.13]) and poor (OR 0.42, 95% CI [0.1-1.73]) functional outcomes compared to the posterior approach. In terms of cosmetic results, both approaches showed mixed findings. The lateral approach was more likely to result in excellent (OR 1.11, 95% CI [0.61-2.02]) and fair (OR 1.18, 95% CI [0.49-2.80]) but less likely to result in good (OR 0.79, 95% CI [0.40-1.55]) cosmetic outcomes. However, none of these analyses were statistically significant (p> 0.05).  Conclusion: Lateral and posterior surgical approaches resulted in satisfactory functional and cosmetic outcomes. The two approaches are comparable for treating SHF in children when evaluated with Flynn’s criteria.

scholarly journals Behind the Scene: Exploiting MC1R in Skin Cancer Risk and Prevention

Genes ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 1093
Author(s):  
Michele Manganelli ◽  
Stefania Guida ◽  
Anna Ferretta ◽  
Giovanni Pellacani ◽  
Letizia Porcelli ◽  
...  
Keyword(s):  
Melanocortin 1 Receptor ◽  
Additional Risk ◽  
Ultraviolet Exposure ◽  
Skin Cancers ◽  
Increased Risk ◽  
Rising Incidence ◽  
The Impact ◽  
Common Malignancy ◽  
Melanoma Skin

Melanoma and non-melanoma skin cancers (NMSCs) are the most frequent cancers of the skin in white populations. An increased risk in the development of skin cancers has been associated with the combination of several environmental factors (i.e., ultraviolet exposure) and genetic background, including melanocortin-1 receptor (MC1R) status. In the last few years, advances in the diagnosis of skin cancers provided a great impact on clinical practice. Despite these advances, NMSCs are still the most common malignancy in humans and melanoma still shows a rising incidence and a poor prognosis when diagnosed at an advanced stage. Efforts are required to underlie the genetic and clinical heterogeneity of melanoma and NMSCs, leading to an optimization of the management of affected patients. The clinical implications of the impact of germline MC1R variants in melanoma and NMSCs’ risk, together with the additional risk conferred by somatic mutations in other peculiar genes, as well as the role of MC1R screening in skin cancers’ prevention will be addressed in the current review.

scholarly journals Functional outcomes in children with reduction glossectomy for vascular malformations - "less is more!"

2021 ◽  
Vol 47 (3) ◽  
pp. 209-215
Author(s):  
John K. Thomas ◽  
Vivek Samuel Gaikwad ◽  
Telugu Ramesh Babu ◽  
John Mathai ◽  
Rohit Srinivas ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Vascular Malformations ◽  
Less Is More

Interventions to Increase Sunscreen Use in Adults: A Review of the Literature

2021 ◽  
pp. 109019812110465
Author(s):  
Nicholas Allen ◽  
Diona L. Damian
Keyword(s):  
Skin Cancer ◽  
Cost Effective ◽  
Squamous Cell Carcinomas ◽  
Future Research ◽  
Review Of The Literature ◽  
Sunscreen Use ◽  
Skin Cancers ◽  
Basal Cell Carcinomas ◽  
Daily Application ◽  
Common Malignancy

Skin cancers are the most common malignancy in Australia. Regular sunscreen use can reduce the incidence of cutaneous squamous cell carcinomas and actinic keratoses and has been associated with reducing the incidence of basal cell carcinomas and melanomas. However, sunscreen effectiveness is limited by the failure of the population to use it routinely. Interventions that promote the daily application of sunscreen may reduce the morbidity, mortality, and economic burden associated with skin malignancies. We reviewed the literature that examines the effectiveness of interventions to increase routine sunscreen use and found that no one strategy has been shown to be clearly effective in adults and that relatively few studies have aimed to increase routine use in groups at extreme skin cancer risk. Future research should consider how interventions can be best designed and how sunscreen use is measured so that cost-effective, feasible strategies that result in improved sunscreen use in adults can be established.

scholarly journals NEW SOLUTIONS IN NASAL ALA RECONSTRUCTION

2018 ◽  
pp. 36-42
Author(s):  
S. A. Ivanov
Keyword(s):  
Functional Outcomes ◽  
Single Stage ◽  
Point Scale ◽  
Partial Necrosis ◽  
Nasal Ala ◽  
Donor Area ◽  
Nasal Function ◽  
Anatomical Outcome ◽  
Ala Reconstruction ◽  
And Cartilage

The article describes the technique and results of the method of single-stage nasal ala reconstruction based on a modified puzzle-flap. The developed method has been applied for nasal ala reconstruction in 10 patients after malignant tumor excision. The anatomical and functional outcomes of the reconstruction were evaluated with the use of NAFEQ questioning and visual analogue scale. The external skin, internal nasal lining, and cartilage support of nasal ala were restored in a single-stage procedure in all the cases. The natural appearance and contour of neoala were achieved with a minimal correction in the donor area. Partial necrosis of a flap was observed in one case. The anatomical outcome of the reconstruction was evaluated as completely satisfactory or satisfactory in 9 out of 10 patients (90%) according to NAFEQ. The average evaluation of the results of the reconstruction by the VAS scale was 81.0 ± 6.8 (100-point scale), the minimal value - 70 points, the maximal one - 95 points. Nasal function was not disturbed in any case. The proposed method of nasal ala reconstruction allows to achieve acceptable functional and anatomical results in a single-stage procedure.

scholarly journals Prosthesis ventral colpo-recto-pexy for the restoration of the recto-anal anatomic disorders

2016 ◽  
Vol 63 (1) ◽  
pp. 83-88
Author(s):  
Evanghelos Xynos
Keyword(s):  
Rectal Prolapse ◽  
Functional Outcomes ◽  
Obstructed Defecation ◽  
Pelvic Surgery ◽  
Current Evidence ◽  
Safe Procedure ◽  
Open Approach ◽  
Functional Disorders ◽  
Comparative Trials

There is a variety of anatomical deformities of the posterior pelvic compartment that associate functional disorders of the anorectum. The most common are: anterior rectocele, internal rectal prolapse (recto-anal intussusception), sigmoidcele and enterocele and overt rectal prolapse. There are a number of procedures employed in the treatment of mentioned disorders. One of them is laparoscopic prosthesis ventral colpo-rectopexy. Current evidence on this procedure is rather limited, because quality of studies is of low level and comparative trials are very few. Nevertheless, it is well documented that this procedure for mentioned is a safe procedure with very low morbidity, one death reported so far, and low conversion-to-open approach rate. Complications associated with the synthetic prosthesis (erosion or sepsis) are rare, and use of biological mesh does not seem to offer any advantage. Conversion is very low and usually as a result of previous pelvic surgery. The procedure is safe with low morbidity, short hospital stay and very low recurrence rate of overt rectal prolapse. Functional outcomes, namely constipation, obstructed defecation syndrome, incontinence and sexual dysfunction decrease in rates postoperatively.

scholarly journals Concurrent Tumors in Patients with Hematologic Malignancies

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5997-5997
Author(s):  
Luis David Sumoza ◽  
Marina Messinger ◽  
Patricia Sumoza ◽  
Roxana Aguirre ◽  
Poola Harsha ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Conflicts Of Interest ◽  
Hematologic Malignancy ◽  
Hematologic Malignancies ◽  
Cook County ◽  
Tumor Registry ◽  
Secondary Tumors ◽  
Skin Cancers ◽  
Metachronous Neoplasm ◽  
Common Malignancy

Abstract Background: Secondary tumors has been described in a variety of patients with either hematologic malignancies or solid neoplasm, and most of the time is related to previous chemotherapy and radiation therapy exposure, but little is found in the literature about synchronous or metachronous neoplasm that can be found in patient with a newly diagnosis of hematologic malignancy; we report 45 cases, presented in a single institution from 2007 to present. Methods: A retrospective review of records using our tumor registry data, from patient with hematologic malignancies at John H. Stroger Hospital of Cook County, was performed and 45 patients with either synchronous or metachronous neoplasm were identified. Results: Lung cancer was the most common malignancy representing 22.2%, Colorectal cancer 20%, Prostate cancer 17.7%, Breast cancer 11.1%, Urothelial cancer (Kidney and Bladder) 8.8%, Myelodisplastic syndrome, Pancreatic cancer, Thyroid cancer, Non-Hodgking lymphoma, Acute Myeloide Leukemia, Vulvar cancer, Testicular cancer and Skin Cancers 2.2% each one respectively. Results: We found that in our heterogeneous population of patient with hematologic malignancies, the incidence of synchronous or metachronous neoplasm practically follows a very similar pattern of the general population, despite that many of this patients have been exposed to chemotherapy and radiation therapy. Disclosures No relevant conflicts of interest to declare.

scholarly journals Lateral versus posterior surgical approach for the treatment of supracondylar humeral fractures in children: a systematic review and meta-analysis

F1000Research ◽  
2022 ◽  
Vol 10 ◽  
pp. 573
Author(s):  
Komang Agung Irianto ◽  
I Putu Gede Pradnyadewa Pradana ◽  
Brigita De Vega
Keyword(s):  
Systematic Review ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Humeral Fracture ◽  
Lateral Approach ◽  
Surgical Approaches ◽  
Eligibility Criteria ◽  
Supracondylar Humeral Fracture ◽  
Fractures In Children ◽  
Cosmetic Outcomes

Background: Supracondylar humeral fracture (SHF) is the most common type of fracture in children. Moreover, lateral and posterior surgical approaches are the most frequently chosen approaches for open reduction surgery in displaced SHF when C-arm is unavailable. However, previous literature showed mixed findings regarding functional and cosmetic outcomes. Currently, no systematic review and meta-analysis has compared these two procedures.  Methods: Our protocol was registered at PROSPERO (registration number CRD42021213763). We conducted a comprehensive electronic database search in MEDLINE, EMBASE, and CENTRAL. Two independent reviewers screened the title and abstract, followed by full-text reading and study selection based on eligibility criteria. The quality of the selected studies was analyzed with the ROBINS-I tool. Meta-analysis was carried out to compare the range of motion (functional outcome) and cosmetic outcome according to Flynn’s criteria. This systematic review was conducted based on PRISMA and Cochrane handbook guidelines.  Results: Our initial search yielded 163 studies, from which we included five comparative studies comprising 231 children in the qualitative and quantitative analysis. The lateral approach was more likely to result in excellent (OR 1.69, 95% CI [0.97-2.93]) and good (OR 1.12, 95% CI [0.61-2.04]) functional outcomes and less likely to result in fair (OR 0.84, 95% CI [0.34-2.13]) and poor (OR 0.42, 95% CI [0.1-1.73]) functional outcomes compared to the posterior approach. In terms of cosmetic results, both approaches showed mixed findings. The lateral approach was more likely to result in excellent (OR 1.11, 95% CI [0.61-2.02]) and fair (OR 1.18, 95% CI [0.49-2.80]) but less likely to result in good (OR 0.79, 95% CI [0.40-1.55]) cosmetic outcomes. However, none of these analyses were statistically significant (p> 0.05).  Conclusion: Lateral and posterior surgical approaches resulted in satisfactory functional and cosmetic outcomes. The two approaches are comparable for treating SHF in children when evaluated with Flynn’s criteria.

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