Structural Fat Grafting to Improve Reconstructive Outcomes in Secondary Cleft Lip Deformity

2017 ◽  
Vol 54 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Christine M. Jones ◽  
Brad T. Morrow ◽  
William B. Albright ◽  
Ross E. Long ◽  
Thomas D. Samson ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Cleft Lip ◽  
Rating Scale ◽  
Average Length ◽  
Care Center ◽  
Case Series ◽  
Fat Grafting ◽  
Retrospective Case ◽  
Student’S T

Objective To describe the technique and results of structural fat grafting in cleft lip revision, including patient satisfaction and aesthetic outcome. Design Retrospective case series Setting Multidisciplinary cleft care center. Patients All patients who underwent structural fat grafting between June 2006 and September 2012 for cleft lip revision, with appropriate photographic follow-up included. Twenty-two cases were reviewed; 18 had sufficient data to be included. Interventions Patients underwent structural fat grafting for cleft lip revision, most commonly injecting fat under deficient philtral columns, the nostril base, and upper lip. Main Outcome Measures Blinded observers rated outcomes using the Asher-McDade nasolabial appearance rating scale. Patients completed questionnaires assessing their satisfaction. A paired Student's t-test was used to test outcomes for significance (alpha = 0.05). Results Patients were an average of 16 years old (range 6-43); average length of follow up was 11.7 months. Overall symmetry and aesthetics were improved based on the nasal form ( P = 0.006) and vermillion border (P - 0.04) when rated using the Asher-McDade scale. No complications were recorded. Patients were significantly happier with their appearance after fat grafting (P < 0.001) and were uniformly positive when questioned about the ease of the surgery and rate of recovery. Conclusions Structural fat grafting is a safe and effective way to improve symmetry and enhance facial proportions in patients with cleft lip. Given the high degree of patient satisfaction, few complications, and durable results, fat grafting offers many advantages in cleft lip revision.

scholarly journals Outcomes of Nitinol Compression Staples in Tarsometatarsal Fusion

2020 ◽  
Vol 5 (3) ◽  
pp. 247301142094490
Author(s):  
Carissa C. Dock ◽  
Katie L. Freeman ◽  
J. Chris Coetzee ◽  
Rebecca Stone McGaver ◽  
M. Russell Giveans
Keyword(s):  
Patient Satisfaction ◽  
Case Series ◽  
Fusion Rate ◽  
Perioperative Outcomes ◽  
Wound Complications ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Patient Satisfaction Score ◽  
Foot Function

Background: Tarsometatarsal (TMT) arthrodesis is commonly performed in the management of midfoot arthritis, trauma, or deformity. The purpose of this study was to collect aggregate data (demographic, surgical, and perioperative outcomes) on patients who previously had a TMT fusion with BME compression staples. Methods: Sixty-six patients underwent TMT fusion with BME compression staples. Outcomes included demographics, surgical information, the Veterans Rand VR-12 Health Survey, Foot and Ankle Ability Measure (FAAM), visual analog scale (VAS), Revised-Foot Function Index (FFI-R), Ankle Osteoarthritis Scale (AOS), patient satisfaction survey scores, radiographic fusion rate, level of pain reduction, and complications. Sixty-six patients (68 feet) were analyzed (59 females) with an average age of 64 years (range, 18-83). The mean latest follow-up was 35.9 (range, 6-56.6 months). Results: The average surgical time was 38.1±14.3 minutes (range, 11-75). All outcomes improved significantly ( P < .001) from preoperative to latest follow-up except for the VR-12 Mental and Physical score. The average time to fusion determined by radiographs was 8.4 weeks (range, 6.1-46.1 weeks). Wound complications were not seen. Indications for subsequent surgeries (26.5%, 18/68 feet) in this current study included pain (n = 14), broken staples, and nonunion (n = 3). Conclusions: The fusion rate in this study, 89.7%, was similar to values reported in the literature. The patient satisfaction score of 81.9 at latest follow-up is consistent with patient satisfaction for other methods of fusion. Level of Evidence: Level IV, retrospective case series.

scholarly journals Anterior Cruciate Ligament Reconstruction with LARS Artificial Ligament—Clinical Results after a Long-Term Follow-Up

Joints ◽  
2018 ◽  
Vol 06 (02) ◽  
pp. 075-079 ◽  
Author(s):  
Paolo Parchi ◽  
Gianluca Ciapini ◽  
Carlo Paglialunga ◽  
Michele Giuntoli ◽  
Carmine Picece ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Rating Scale ◽  
Cruciate Ligament ◽  
Case Series ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Anterior Cruciate

Purpose The aim of this retrospective study was to evaluate the subjective and functional outcome of anterior cruciate ligament (ACL) reconstruction with the synthetic Ligament Advanced Reinforcement System (LARS) ligament. Methods Twenty-six patients were reviewed at an average follow-up of 11.6 years. Objective clinical evaluation was performed with stability tests. Patient-reported outcomes (Visual Analogue Scale, Knee Injury and Osteoarthritis Outcome Score, and Cincinnati Knee Rating Scale) were used to assess subjective and functional outcomes. Results Overall satisfactory results were obtained in 22 cases (84.6%). Four patients (15.4%) showed mechanical failure of the graft. No cases of synovitis or infection were reported. Conclusion LARS ligament can be considered a safe and suitable option for ACL reconstruction in carefully selected cases, especially elderly patients needing a rapid postoperative recovery. Level of Evidence Level IV, retrospective case series.

Two hundred and forty-eight cases of visual snow: A review of potential inciting events and contributing comorbidities

Cephalalgia ◽  
2021 ◽  
pp. 033310242199635
Author(s):  
Dev G Mehta ◽  
Ivan Garza ◽  
Carrie E Robertson
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Cortical Atrophy ◽  
Posterior Cortical Atrophy ◽  
Retrospective Case ◽  
Triggering Events ◽  
Perception Disorder ◽  
Visual Disturbances

Objective To review characteristics and outcomes of all cases of visual snow seen at our institution, with attention to possible triggering events or comorbidities. Methods This is a retrospective case series of patients seen at our tertiary care center from January 1994 to January 2020. Charts were reviewed if they contained the term “visual snow”. Results Of the 449 charts reviewed, 248 patients described seeing visual snow in part or all of their vision. Thirty-eight reported transient visual snow as their typical migraine aura. Of the remaining 210 patients, 89 were reported to have either an inciting event or contributing comorbidity for their visual snow symptoms, including: Post-concussion (n = 15), dramatic change in migraine or aura (n = 14), post-infection (n = 13), hallucinogen persisting perception disorder (n = 10), ocular abnormalities (n = 7), idiopathic intracranial hypertension (n = 4), neoplastic (n = 1), and posterior cortical atrophy (n = 1). Some patients had partial improvement with benzodiazepines (n = 6), lamotrigine (n = 5), topiramate (n = 3) and acetazolamide (n = 3). Presenting characteristics were similar, but patients with visual snow attributed to an inciting event or contributing comorbidity were more likely to have some improvement in their symptoms by last follow-up compared to spontaneous visual snow ( p < .001). Conclusions Though most cases of visual snow are spontaneous, potential secondary causes should be recognized by clinicians. Patients who develop visual snow after an inciting event or related to an underlying comorbidity may have a better prognosis than those in whom it develops spontaneously. In select cases, treatment of the suspected underlying cause may significantly alleviate the otherwise typical intractable visual disturbances associated with visual snow.

scholarly journals Clinical Advantages and Limitations of Monolithic Zirconia Restorations Full Arch Implant Supported Reconstruction: Case Series

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Joao Carames ◽  
Loana Tovar Suinaga ◽  
Yung Cheng Paul Yu ◽  
Alejandro Pérez ◽  
Mary Kang
Keyword(s):  
Patient Satisfaction ◽  
Survival Rate ◽  
Case Series ◽  
Implant Survival ◽  
Retrospective Case ◽  
High Patient Satisfaction ◽  
Implant Placement ◽  
Cad Cam ◽  
Monolithic Zirconia

Purpose. The purpose of this retrospective case series is to evaluate the clinical advantages and limitations of monolithic zirconia restorations for full arch implant supported restorations and report the rate of complications up to 2 years after insertion.Materials and Methods. Fourteen patients received implant placement for monolithic zirconia full arch reconstructions. Four implants were placed in seven arches, eleven arches received six implants, two arches received seven implants, two arches received eight implants, and one arch received nine implants.Results. No implant failures or complications were reported for an implant survival rate of 100% with follow-up ranging from 3 to 24 months.Conclusions. Monolithic zirconia CAD-/CAM-milled framework restorations are a treatment option for full arch restorations over implants, showing a 96% success rate in the present study. Some of the benefits are accuracy, reduced veneering porcelain, and minimal occlusal adjustments. The outcome of the present study showed high success in function, aesthetics, phonetics, and high patient satisfaction.

Long-term outcomes of pediatric traumatic cataracts and retinal detachments due to self-inflicted injuries

2020 ◽  
pp. 112067212092645
Author(s):  
Tina Felfeli ◽  
Kamiar Mireskandari ◽  
Asim Ali
Keyword(s):  
Retinal Detachment ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Long Term Outcomes ◽  
Retrospective Case ◽  
Surgical Interventions ◽  
Severe Visual Loss

Purpose To report the characteristics and longitudinal visual outcomes of traumatic cataracts and retinal detachments in children with self-inflicted injury. Methods A retrospective case series of pediatric patients at a tertiary care center who sustained ocular trauma due to self-inflicted injury between 2000 and 2014. Results A total of 11 children, all with an intellectual disability and a mean age of 10 ± 4.8 years (range, 2.8–16.2), were identified with traumatic cataract secondary to ocular self-inflicted injury over the study period. Five eyes had a concurrent unilateral retinal detachment. Over the course of follow-up, one additional eye developed a cataract and five eyes developed a retinal detachment. Patients underwent an average of 2.5 ± 2.3 procedures and 17.1 ± 10.7 eye examinations over 11.7 ± 4.2 years of follow-up; 36% required general anesthesia for examination. Visual acuity was improved or preserved in 77% of the eyes that underwent surgical interventions, but was worse in the remaining cases due to development of traumatic retinal detachment. The use of protective helmets, eye shields, and immobilizing orthoses were essential in management of active self-inflicted injury. Conclusion Traumatic cataracts and retinal detachments due to self-inflicted injury may cause severe visual loss. Visual prognosis although poor in children with severe intellectual disabilities may be optimized with risk awareness for early detection and customized interventions.

Correction of Post-Cleft Lip Nostril Floor Stenosis: Para-Alar Flap Combined With Lip Revision

2020 ◽  
pp. 105566562098022
Author(s):  
Karam A. Allam ◽  
Ahmed Elsherbiny
Keyword(s):  
Cleft Lip ◽  
Donor Site ◽  
Case Series ◽  
Retrospective Case ◽  
Case Series Study ◽  
Secondary Deformity ◽  
Reconstructive Option ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair

Post-cheiloplasty nostril floor stenosis is a scarcely reported secondary deformity. The aim of the current study was to assess the outcome of para-alar flap for management of nostril floor stenosis post-unilateral cleft lip repair. This is a retrospective case series study reviewing consecutive patients presenting with nostril floor stenosis following repair of unilateral cleft lip who were managed by the inferiorly based para-alar flap and lip revision. Differential nostril width was measured preoperative, immediate, and late postoperative. We reported 8 patients (3 boys and 5 girls) with an average age of 9.8 years (range: 4.5-19). Satisfactory results with good nostril symmetry measures were achieved, and no restenosis has been observed during the follow-up periods. The donor site scars were negligible. There was no reported partial or total flap loss. Para-alar flap was found to be an effective reconstructive option for patients with nostril floor stenosis post-unilateral cleft lip repair and can be combined safely with cleft lip revision.

scholarly journals Single implant-supported two-unit cantilever fixed partial dentures in the posterior region: a retrospective case series with a mean follow-up of 6.5 years

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Charlotte Jensen-Louwerse ◽  
Harjan Sikma ◽  
Marco S. Cune ◽  
Felix L. Guljé ◽  
Henny J. A. Meijer
Keyword(s):  
Patient Satisfaction ◽  
Survival Rate ◽  
Case Series ◽  
Posterior Region ◽  
Marginal Bone Loss ◽  
Retrospective Case ◽  
Radiographic Outcomes ◽  
Technical Complications ◽  
Single Implant

Abstract Background The aim of this retrospective study was to evaluate the implant survival, clinical and radiographic outcomes, and patient satisfaction of single implant-supported two-unit cantilever fixed partial dentures in the posterior region. Methods Patients who received a single implant-supported fixed partial denture with a cantilever in the posterior region between January 2004 and February 2018 were included. Survival rate of the implants and the fixed partial dentures and data regarding the marginal bone level, presence of plaque, calculus, bleeding on probing, mucosa health, pocket probing depth, and patient satisfaction were collected during an evaluation visit. Complications were recorded from the medical records. Results Twenty-three patients (mean age 64 ± 13 years) with 28 implants could be included in the study. The mean follow-up period was 6.5 ± 4.8 years at the time of data collection. The survival rate of the implants and fixed partial dentures was 100%. Mean marginal bone loss for the mesial and distal side of the implants was 0.41 mm (SD 1.18 mm) and 0.63 mm (SD 0.98 mm) respectively. A high prevalence of peri-implant-mucositis (89.3%) and peri-implantitis (17.9%) was observed as well as a limited number of technical complications. Patients were quite satisfied, as reflected by a mean VAS score of 94.0 ± 7.2 points (range 0–100) and a OHIP-NL49 score of 10.8 (range 0–196). Conclusions Single implant-supported fixed partial dentures with a mesial or distal cantilever can be a predictable treatment option in the posterior region, with stable peri-implant bone levels, minor technical complications, and very content patients. However, the prevalence of peri-implant mucositis and peri-implantitis was high. Trial registration ISRCTN, ISRCTN79055740, Registered on March 14, 2021 – —Retrospectively registered.

Modified Minimal Incision Subcapital Osteotomy for Hallux Valgus Correction

2013 ◽  
Vol 6 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Andrea Scala ◽  
Domenico Vendettuoli
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Rating Scale ◽  
Case Series ◽  
Invasive Procedure ◽  
Delayed Union ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Minimal Incision ◽  
Student’S T

The potential advantages of minimal incision surgery for hallux valgus (HV) correction are the following: reduced surgical exposure, diminished soft-tissue stripping, and less blood supply impairment. These advantages imply fewer complications. We retrospectively reviewed patients who were consecutively treated with a modified minimally invasive osteotomy from January 2006 until December 2009 for HV deformity. We radiographically assessed the HV angle, 1-2 intermetatarsal (IM) angle, and tibial sesamoid position. Clinical outcomes were determined using the American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal Interphalangeal (AOFAS HMI) Clinical Rating Scale. A paired Student’s t test was used to determine significance, with P < .01. There were 126 patients (146 feet) with an average age of 52.6 years and an average postoperative follow-up of 29.1 months. Preoperatively, the average HV angle was 32.3°, and postoperatively, it was 4.5° (P < .01). The preoperative average IM angle was 14.4°, whereas postoperatively, it was 4.8° (P < .01). The average tibial sesamoid position was 6.3 preoperatively and 2.5 postoperatively (P < .01). The average AOFAS HMI score was 54.6 preoperatively and 85.3 postoperatively (P < .01). There were 15 postoperative complications (10.3%) that included hallux varus, painful hardware, and delayed union. The results are comparable with those of traditional open techniques, with the additional advantages of a minimally invasive procedure. Level of Evidence: Therapeutic, Level IV: Retrospective case series

scholarly journals THU0319 DEVELOPMENT AND OUTCOME OF AORTIC COMPLICATIONS DURING TOCILIZUMAB TREATMENT OF GCA AND HISTOPATHOLOGIC EVIDENCE OF RESIDUAL INFLAMMATION-A CASE SERIES.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 388.2-389
Author(s):  
A. Rubbert-Roth ◽  
P. K. Bode ◽  
T. Langenegger ◽  
C. Pfofe ◽  
T. Neumann ◽  
...  
Keyword(s):  
Structural Changes ◽  
Case Series ◽  
Aortic Aneurysms ◽  
Imaging Data ◽  
Limited Data ◽  
Retrospective Case ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Background:Giant cell arteritis (GCA) may affect the aorta and the large aortic branches and lead to dissections and aortic aneurysms. Tocilizumab (TCZ) treatment has the capacity to control aortic inflammation as has been demonstrated by CRP normalization and imaging data. However, limited data are available on the histopathological findings obtained from patients who underwent surgery because of aortic complications during TCZ treatment.Objectives:We report on 5 patients with aortitis who were treated with TCZ and developed aortic complications.Methods:We describe a retrospective case series of patients with GCA treated with TCZ, who presented in our clinic between 2011 and 2019. Three patients underwent surgery. Histopathologic examination was performed in specimen from all of them.Results:Five female patients were diagnosed with GCA (4/5) or Takaysu arteritis (1/5) involving the aorta, all them diagnosed by MR angiography and/or FDG PET CT scan. Three patients (one with aortic aneurysm, one with dissection) underwent surgery after having been treated with TCZ for seven weeks, nine months and four years, respectively. Imaging before surgery showed remission on MRI and/or PET-CT in all cases. At the time of surgery, all patients showed normalized CRP and ESR values. Histopathological evaluation of the aortic wall revealed infiltrates, consisting predominantly of CD3+CD4+ T cells. Enlargement of pre-existing aneuryms was observed in the other two patients 10 weeks and 4 months after discontinuation of TCZ, respectively. Both patients were not eligible for surgical intervention and died during follow-up.Conclusion:Our case series suggests that during treatment with TCZ, regular imaging is necessary in this patient population to detect development of structural changes such as aneurysms or dissections. Despite treatment, residual inflammation might persist which could contribute to eventual aortic complications.Disclosure of Interests:Andrea Rubbert-Roth Consultant of: Abbvie, BMS, Chugai, Pfizer, Roche, Janssen, Lilly, Sanofi, Amgen, Novartis, Peter Karl Bode: None declared, Thomas Langenegger: None declared, Claudia Pfofe: None declared, Thomas Neumann: None declared, Olaf Chan-Hi Kim: None declared, Johannes von Kempis Consultant of: Roche

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