scholarly journals Namaste (counterbalancing) technique: Overcoming warping in costal cartilage

2015 ◽  
Vol 48 (02) ◽  
pp. 123-128 ◽  
Author(s):  
Kapil S. Agrawal ◽  
Manoj Bachhav ◽  
Raghav Shrotriya
Keyword(s):  
Large Volume ◽  
Simple Technique ◽  
Costal Cartilage ◽  
Cartilage Grafts ◽  
Major Disadvantage

ABSTRACT Background: Indian noses are broader and lack projection as compared to other populations, hence very often need augmentation, that too by large volume. Costal cartilage remains the material of choice in large volume augmentations and repair of complex primary and secondary nasal deformities. One major disadvantage of costal cartilage grafts (CCG) which offsets all other advantages is the tendency to warp and become distorted over a period of time. We propose a simple technique to overcome this menace of warping. Materials and Methods: We present the data of 51 patients of rhinoplasty done using CCG with counterbalancing technique over a period of 4 years. Results: No evidence of warping was found in any patient up to a maximum follow-up period of 4 years. Conclusion: Counterbalancing is a useful technique to overcome the problem of warping. It gives liberty to utilize even unbalanced cartilage safely to provide desired shape and use the cartilage without any wastage.

Long-term Use and Follow-up of Irradiated Homologous Costal Cartilage Grafts in the Nose

2009 ◽  
Vol 11 (6) ◽  
Author(s):  
Russell W. H. Kridel ◽  
Faramarz Ashoori ◽  
Edmund S. Liu ◽  
Carol G. Hart
Keyword(s):  
Costal Cartilage ◽  
Cartilage Grafts

Long-term Use and Follow-up of Irradiated Homologous Costal Cartilage Grafts in the Nose

2009 ◽  
Vol 11 (6) ◽  
pp. 378-394 ◽  
Author(s):  
Russell W. H. Kridel ◽  
Faramarz Ashoori ◽  
Edmund S. Liu ◽  
Carol G. Hart
Keyword(s):  
Costal Cartilage ◽  
Cartilage Grafts

scholarly journals Indications and Long-term Outcomes of Open Augmentation Rhinoplasty with Autogenous L-shaped Costal Cartilage Strut Grafts – A Single Plastic Surgeon’s Experience

2018 ◽  
Vol 72 (3) ◽  
pp. 20-29 ◽  
Author(s):  
Laura Leach ◽  
Eamon Shamil ◽  
Charles M. Malata
Keyword(s):  
Costal Cartilage ◽  
Relapsing Polychondritis ◽  
Patient Reported Outcome ◽  
Patient Questionnaire ◽  
Long Term Outcomes ◽  
Augmentation Rhinoplasty ◽  
Cartilage Grafts ◽  
Patient Reported

Introduction We present a single surgeon’s experience of open augmentation rhinoplasty with autogenous L-shaped costal cartilage grafts, with long-term patient-reported outcome data. We highlight the salient operative steps and outline the peri-operative care required to optimise outcomes. Materials and Methods A retrospective review of eleven such augmentation rhinoplasties performed between 2008 and 2016 was undertaken. Indications included saddle nose deformity [granulomatosis with polyangiitis (n=7) and relapsing polychondritis (n=1)], post-traumatic nasal collapse (n=1) and advanced cosmetic westernisation of the nose (n=2). Long-term patient-reported outcome was assessed with a patient questionnaire. Results All patients achieved marked improvement in nasal position, shape and function. There was no cartilage exposure, warping or resorption and no recurrent deformities. One patient’s dorsal graft was fractured two years later during an ophthalmological procedure and the deformity was re-corrected successfully, again with the above technique. Average follow up was 5.2 years. Of the nine patients who responded to the follow-up questionnaire, 100% were satisfied with their nasal appearance. 100% of responders at follow-up reported that they have had no problems relating to their nose (n=9). Discussion L-shaped costal cartilage grafts provided a reliable, reproducible approach in augmentation rhinoplasty for disparate indications (inflammatory, traumatic and cosmetic) in the hands of a low-volume operator. With careful patient selection and planning, this technique can provide pleasing aesthetic outcomes and high patient satisfaction, with good long-term outcomes.

Outcome of Buccal Mucosal Graft Urethroplasty in Long Segment Anterior Urethral Stricture

2020 ◽  
Vol 19 (2) ◽  
pp. 64-68
Author(s):  
Mrinmoy Biswas ◽  
Sudip Das Gupta ◽  
Mohammed Mizanur Rahman ◽  
Sharif Mohammad Wasimuddin
Keyword(s):  
Urethral Stricture ◽  
Flow Rate ◽  
Surgical Outcome ◽  
Simple Technique ◽  
Anterior Segment ◽  
Maximum Flow ◽  
Anastomotic Site ◽  
Buccal Mucosal Graft ◽  
Male Patients

Objective: To assess the success of BMG urethroplasty in long segment anterior urethral stricture. Method: From January 2014 to December 2015, twenty male patients with long anterior segment urethral stricture were managed by BMG urethroplasty. After voiding trial they were followed up at 3 month with Uroflowmetry, RGU & MCU and PVR measurement by USG. Patients were further followed up with Uroflowmetry and PVR at 6 months interval.Successful outcome was defined as normal voiding with a maximum flow rate >15ml /sec and PVR<50 ml with consideration of maximum one attempt of OIU after catheter removal. Results: Mean stricture length was 5.2 cm (range 3-9 cm) and mean follow-up was 15.55 months (range 6-23 months). Only two patients developed stricture at proximal anastomotic site during follow-up. One of them voided normally after single attempt of OIU. Other one required second attempt of OIU and was considered as failure (5%). Conclusion: BMG urethroplasty is a simple technique with good surgical outcome. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.64-68

Tracheocutaneous Fistula After Pediatric Open Airway Reconstruction

2021 ◽  
pp. 000348942098742
Author(s):  
Stephen R. Chorney ◽  
Joanne Stow ◽  
Luv R. Javia ◽  
Karen B. Zur ◽  
Ian N. Jacobs ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Case Series ◽  
Primary Objective ◽  
Multivariable Logistic Regression Analysis ◽  
Pediatric Airway ◽  
Surgical Closure ◽  
Laryngotracheal Reconstruction ◽  
Airway Reconstruction ◽  
Tracheocutaneous Fistula

Objectives: Tracheocutaneous fistula (TCF) is a common occurrence after pediatric tracheostomy decannulation. However, the persistence of TCF after staged reconstruction of the pediatric airway is not well-described. The primary objective was to determine the rate of persistent TCF after successful decannulation in children with staged open airway reconstruction. Methods: A case series with chart review of children who underwent decannulation after double-stage laryngotracheal reconstruction between 2017 and 2019. Results: A total of 26 children were included. The most common open airway procedure was anterior and posterior costal cartilage grafting (84.6%, 22/26). Median age at decannulation was 3.4 years (IQR: 2.8-4.3) and occurred 7.0 months (IQR: 4.3-10.4) after airway reconstruction. TCF persisted in 84.6% (22/26) of children while 15.4% (4/26) of stomas closed spontaneously. All closures were identified by the one-month follow-up visit. There was no difference in age at tracheostomy ( P = .86), age at decannulation ( P = .97), duration of tracheostomy ( P = .43), or gestational age ( P = .23) between stomas that persisted or closed. Median diameter of stent used at reconstruction was larger in TCFs that persisted (7.0 mm vs 6.5 mm, P = .03). Tracheostomy tube diameter ( P = .02) and stent size ( P < .01) correlated with persistence of TCF on multivariable logistic regression analysis. There were 16 surgical closure procedures, which occurred at a median of 14.4 months (IQR: 11.4-15.4) after decannulation. Techniques included 56.3% (9/16) by primary closure, 18.8% (3/16) by secondary intention and 25% (4/16) by cartilage tracheoplasty. The overall success of closure was 93.8% (15/16) at latest follow-up. Conclusions: Persistent TCF occurs in 85% of children who are successfully decannulated after staged open airway reconstruction. Spontaneous closure could be identified by 1 month after decannulation and was more likely when smaller stents and tracheostomy tubes were utilized. Surgeons should counsel families on the frequency of TCF and the potential for additional procedures needed for closure.

A new surgical technique for the treatment of scaphotrapezial arthritis associated with trapeziometacarpal arthritis: the narrow pseudoarthrosis

2016 ◽  
Vol 41 (7) ◽  
pp. 710-718 ◽  
Author(s):  
M. Rubino ◽  
L. Cavagnaro ◽  
V. Sansone
Keyword(s):  
Simple Technique ◽  
Stage Iv ◽  
Pinch Strength ◽  
Dash Score ◽  
Level Of Evidence ◽  
First Ray ◽  
Excision Arthroplasty ◽  
Surgical Treatments ◽  
New Surgical Technique

We describe a technique for treating Eaton stage IV osteoarthritis of the first ray, which is a development of our previously published technique for treating trapeziometacarpal arthritis. This simple technique is based on a limited resection arthroplasty of the first trapeziometacarpal and the scaphotrapezial joints, with the aim of inducing the formation of a narrow pseudoarthrosis at both sites. A total of 26 consecutive patients were treated for Eaton stage IV arthritis at a mean follow-up of 4.7 years (range 3.2–6.6). There were statistically significant improvements in all clinical parameters: mean appositional and oppositional pinch strength, mean DASH score (65 points pre-operatively to 8.7 points at final follow-up), and in mean visual analogue scale score (8.6 to 0.2 points). Although a larger cohort and a longer follow-up will be necessary to evaluate this new technique fully, these results encourage us to believe that the limited excision arthroplasty of the trapeziometacarpal and scaphotrapezial joints is a viable alternative to the existing surgical treatments for stage IV thumb arthritis. Level of evidence: 4

A Simple Technique for Seed Transfer in X-ray Analysis of Seed

1974 ◽  
Vol 4 (3) ◽  
pp. 407-409
Author(s):  
B. S. P. Wang
Keyword(s):  
Simple Technique ◽  
Seedling Vigor ◽  
X Ray ◽  
Seed Germinability ◽  
Seed Transfer ◽  
Follow Up Study ◽  
Germinating Seeds ◽  
Tree Seed

Using X-radiography both for the follow-up study of germination and the correlation of tree seed germinability with embryo and endosperm (or megagametophyte) development often involve seed transfer by hand. Such a procedure is tedious and time-consuming and errors of seed displacement occur frequently. Conventional germination procedures also make counting germinants and evaluating seedling vigor difficult due to the shifting of positions of germinating seeds. A simple technique of using a combination of mechanized vacuum counting plate and perforated Plexiglas templates was devised to overcome these difficulties. It decreased by 40 times the time needed to transfer 400 seeds by hand. It also reduced errors of seed displacement.

scholarly journals Extending Coronectomy Indications to Third Molars with Taurodontism to Prevent Paresthesia and Mandible Fracture

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Polianne Alves Mendes ◽  
Isabela Moreira Neiva ◽  
Cláudia Borges Brasileiro ◽  
Ana Cristina Rodrigues Antunes Souza ◽  
Leandro Napier Souza
Keyword(s):  
High Risk ◽  
Female Patient ◽  
Postoperative Period ◽  
Simple Technique ◽  
Mandibular Fracture ◽  
The Body ◽  
Third Molars ◽  
Mandible Fracture ◽  
Angle Fracture

Taurodontism is considered a dental anomaly responsible for a morphoanatomical change in the shape of the tooth in which the roots are reduced in size but the body of the tooth is enlarged and bulky. The aim of this paper is to present a case of a 25-year-old female patient with taurodontism of mandibular partially erupted third molars, presenting a high risk of angle fracture and paresthesia in case of their removal, treated by means of coronectomy. The postoperative period was uneventful and the patient remained in follow-up for 12 months. In conclusion, the identification of third molars with higher risk of complications related to their extractions is the key to consider conservative measures to avoid problems. Coronectomy is a relatively simple technique that should be taken into account when considering bulky, deeply located third molars with a high risk of paresthesia or mandibular fracture, even in presence of taurodontism.

Nasal Reconstruction of a Frontonasal Dysplasia via Septal L-Strut Reconstruction Using Costal Cartilage

2021 ◽  
pp. 105566562110366
Author(s):  
Yong Bae Kim ◽  
Seung Min Nam ◽  
Eun Soo Park ◽  
Chang Yong Choi ◽  
Han Gyu Cha ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
General Anesthesia ◽  
Retrospective Review ◽  
Costal Cartilage ◽  
Point Of View ◽  
Nasal Reconstruction ◽  
Open Rhinoplasty ◽  
Frontonasal Dysplasia ◽  
Congenital Condition

Objective Frontonasal dysplasia (FND) is a rare congenital condition. Its major features include hypertelorism, a large and bifid nasal tip, and a broad nasal root. We present our technique of septal L-strut reconstruction using costal cartilage. Design Retrospective review from June 2008 and August 2017. Methods Under general anesthesia, 6 patients with FND underwent septal reconstruction using costal cartilage via open rhinoplasty. We reconstructed the nasal and septal cartilaginous framework by placing columellar struts and cantilever-type grafts. Results The patients ranged in age from 6 to 13 years old. All were female. The follow-up period ranged from 8 months to 2 years; we encountered no postoperative complications (infection, nasal obstruction, or recurrence). All patients were satisfied with their nasal appearance. Conclusions Although the results were not entirely satisfactory from an esthetic point of view, we found that FND can be treated via septal reconstruction with costal cartilage and that the clinical outcomes are reliable and satisfactory. Our approach is a useful option for FND patients.

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