scholarly journals A practical approach to nasal reconstruction in Asian patients

2021 ◽  
Vol 22 (5) ◽  
pp. 268-275
Author(s):  
In Suk Koh ◽  
Hook Sun
Keyword(s):  
Postoperative Complications ◽  
Treatment Guidelines ◽  
Comprehensive Evaluation ◽  
Secondary Infection ◽  
Nasal Reconstruction ◽  
Asian Patients ◽  
Post Traumatic ◽  
Caucasian Patients ◽  
Advancement Flaps ◽  
Nasal Defects

Background: The study aimed to evaluate nasal reconstruction techniques customized for Asians. The currently available nasal reconstruction guidelines are based on Caucasian patients, and their applicability is limited in Asian patients due to differences in anatomical and structural features.Methods: A retrospective analysis was performed of the medical records of 76 patients who underwent nasal reconstruction at a single center between January 2010 and June 2020. A comprehensive evaluation was conducted of patients’ baseline demographics and clinical characteristics, including age, sex, medical history, defect size and location, reconstructive procedure, pathological diagnosis, postoperative complications, and recurrence.Results: In 59 cases (77%), nasal defects resulted from tumor ablation, and the remaining 17 cases involved post-traumatic (20%) and infection-induced (3%) tissue damage. The most common defect location was the alae, followed by the sidewalls, tip, and dorsum. Forehead flaps were the most commonly used reconstructive technique, followed by nasolabial advancement flaps, rotation flaps, and skin grafts. Each procedure was applied considering aspects of structural anatomy and healing physiology specific to Asians. Complications included nasal deformity, hypertrophic scarring, secondary infection, and partial flap necrosis, but no cases required additional surgical procedures. Tumors recurred in two cases, but tumor recurrence did not significantly affect flap integrity.Conclusion: Nasal reconstruction techniques applied considering Asians’ facial features resulted in fewer postoperative complications and higher patient satisfaction than the approaches that are currently in widespread use. Therefore, this study is expected to serve as an essential reference for establishing treatment guidelines for nasal reconstruction in Asians.

V-Y Advancement Flaps Based on Yotsuyanagi Aesthetic Subunit Principles for Small Nasal Defects in Asian Patients

2016 ◽  
Vol 32 (03) ◽  
pp. 315-319
Author(s):  
Hua Li ◽  
Dathan Hamann ◽  
Fawei Xu ◽  
Zi-chun Gu
Keyword(s):  
Asian Patients ◽  
Advancement Flaps ◽  
Nasal Defects

The V-to-Y Advancement Flap for Distal Nasal Reconstruction: Our Experience With 39 Patients

2018 ◽  
Vol 22 (4) ◽  
pp. 411-414
Author(s):  
Ryan B. Thorpe ◽  
Rajiv I. Nijhawan ◽  
Divya Srivastava
Keyword(s):  
Medical Center ◽  
Advancement Flap ◽  
Single Stage ◽  
Medium Size ◽  
Nasal Reconstruction ◽  
Pedicle Flap ◽  
Flap Design ◽  
Cosmetic Outcomes ◽  
Advancement Flaps ◽  
Nasal Defects

Background and Objective: The V-to-Y advancement flap, also known as the island pedicle flap, is a single-stage repair option that can be used for defects on the distal nose. We report our experience using this flap for nasal defects following Mohs micrographic surgery, as well as describe optimal patient selection and flap design. Materials and Methods: A retrospective review was conducted of all patient charts and operative photographs of nasal V-to-Y advancement flaps performed over 6 years at the Universtiy of Texas Southwestern Medical Center. Charts were reviewed for age, sex, tumour type and location, defect size, anticoagulation, immunosuppression, postoperative complications, revisions, and outcomes. Results: Thirty-nine patients with defects ranging from 0.7 to 1.7 cm in size (median of 1 cm) were included. Most defects involved the inferior, paramedian nose, and after accounting for 7 postrepair interventions on 6 (15%) patients, 38 (97%) patients were noted to have good to excellent cosmetic outcomes while 1 patient experienced a persistent trapdoor effect. Conclusion: The V-to-Y advancement flap is an excellent single-stage option that can reliably provide good to excellent cosmetic results when used to repair small- to medium-size sized defects on the distal half of the nose.

scholarly journals Excellency of Converse Scalping Forehead Flap for Reconstruction of External Nasal Soft-Tissue Defects

2021 ◽  
Vol 29 (1) ◽  
pp. 43-47
Author(s):  
Gaurab Ranjan Chaudhuri
Keyword(s):  
Soft Tissue ◽  
Venous Malformation ◽  
Nasal Reconstruction ◽  
Soft Tissue Defects ◽  
Forehead Flap ◽  
Nasal Defect ◽  
External Nose ◽  
Post Traumatic ◽  
Nasal Defects ◽  
Tissue Defects

Introduction   Reconstruction of external nasal defects poses a challenge for the plastic surgeons. The scalping forehead flap, first described by Converse in 1942 is a versatile technique for subtotal and total external nasal reconstruction. The flap is extremely reliable with robust vascularity and provides excellent colour and texture match for the external nose with minimal donor-site morbidity.   Materials and Methods In this series, eleven patients with external nasal soft-tissue defects (post traumatic and post excisional) were reconstructed with scalping forehead flap; among them four presented with congenital naevus, three with post-traumatic external nasal defect, two presented with basal cell carcinoma, and two with arterio-venous malformation. The age of the patients ranged between 24 and 67 years; eight male and three female patients were included in this study. Among them three had comorbidities like diabetes mellitus and/ hypertension. Results All the flaps survived nicely. I didn’t face any complication in any of my patients. The external nasal defects were reconstructed with scalping forehead flap in two stages with an interval of three weeks in between. Conclusion The Converse scalping forehead flap is an excellent option in the armamentarium of plastic surgeons for subtotal and total nasal reconstruction because of its reliability, vascularity, and simplicity even in the era of microvascular free tissue transfer.

The Influence of Val66Met Polymorphism in Brain-Derived Neurotrophic Factor on Stroke Recovery Outcome: A Systematic Review and Meta-analysis

2021 ◽  
pp. 154596832110141
Author(s):  
Xuan Liu ◽  
Jun-Chao Fang ◽  
Xin-Yue Zhi ◽  
Qiu-Yu Yan ◽  
Hong Zhu ◽  
...  
Keyword(s):  
Neurotrophic Factor ◽  
Genetic Model ◽  
Meta Analysis ◽  
Brain Derived Neurotrophic Factor ◽  
Recessive Model ◽  
Stroke Recovery ◽  
Stroke Severity ◽  
Val66met Polymorphism ◽  
Asian Patients ◽  
Caucasian Patients

Background and purpose. A single nucleotide polymorphism at nucleotide 196 (G/A) in the human brain-derived neurotrophic factor ( BDNF) gene produces an amino acid substitution (valine to methionine) at codon 66(Val66Met). It is unclear whether carriers of this substitution may have worse functional outcomes after stroke. We aimed to explore the distribution of Val66Met polymorphism and evaluate the effect of different genotypes on stroke functional recovery. Methods. Several databases were searched using the keywords BDNF or brain-derived neurotrophic factor, codon66, G196A, rs6265, or Val66Met, and stroke. Results. A total of 25 articles were relevant to estimate the distribution of alleles; 5 reports were applied in the meta-analysis to assess genetic differences on recovery outcomes. The genetic model analysis showed that the recessive model should be used; we combined data for AA versus GA+GG (GG—Val/Val, GA—Val/Met, AA—Met/Met). The results showed that stroke patients with AA might have worse recovery outcomes than those with GA+GG (odds ratio = 1.90; 95% CI: 1.17-3.10; P = .010; I2 = 69.2%). Overall, the A allele may be more common in Asian patients (48.6%; 95% CI: 45.8%-51.4%, I2 = 54.2%) than Caucasian patients (29.8%; 95% CI: 7.5%-52.1%; I2 = 99.1%). However, in Caucasian patients, the frequency of the A allele in Iranians (87.9%; 95% CI: 83.4%-92.3%) was quite higher than that in other Caucasians (18.7%; 95% CI: 16.6%-20.9%; I2 = 0.00%). Conclusion. Val66Met AA carriers may have worse rehabilitation outcomes than GA+GG carriers. Further studies are needed to determine the effect of Val66Met polymorphism on stroke recovery and to evaluate this relationship with ethnicity, sex, age, stroke type, observe duration, stroke severity, injury location, and therapies.

The Differential Diagnosis in Nonlymphoproliferative Malignant Pleural Effusion Cytopathology and Its Correlation with Patients’ Demographics

2018 ◽  
Vol 62 (5-6) ◽  
pp. 436-442 ◽  
Author(s):  
Erika F. Rodriguez ◽  
Sayanan Chowsilpa ◽  
Zahra Maleki
Keyword(s):  
Differential Diagnosis ◽  
African American ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Primary Site ◽  
Gi Tract ◽  
Asian Patients ◽  
Caucasian Patients ◽  
The Impact ◽  
Upper Gastrointestinal

Background: We report our experience with malignant pleural effusion (MPE) and the impact of patients’ demographics on the differential diagnosis at the primary site. Methods: After IRB approval, we searched our pathology database from January 2013 to January 2017 for patients with positive pleural effusions (PEs). Patients’ demographics and clinical histories were noted. Results: 474 patients were identified (288 females [61%] and 186 males [39%]), ranging in age from 19 to 64 years old. Ethnicity was distributed as follows: Caucasian (n = 330, 70%), African American (n = 114, 24%) and Asian (n = 30, 6%). The most common primary sites were the lung (n = 180, 37%), followed by the breast (n = 81, 17%), and the gynecologic system (67, 13%). The lung was the most common primary for all ethnicities (n = 190, 40%). The second-most common primary site was the breast in African Americans and Caucasians and upper gastrointestinal (GI) tract in Asians. In 5 cases (1%), the primary tumor could not be determined. Conclusion: Cytology examination is a useful method to diagnose primary sites of PE. Pulmonary primary is the most common cause of effusion in all ethnicities. In African American and Caucasian patients, the breast was the second-most common site of MPE, while in Asian patients it was the upper GI tract.

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.

Comorbidities and indications for total hip arthroplasty at a tertiary care center in Saudi Arabia

2021 ◽  
Vol 12 (3) ◽  
pp. 59-63
Author(s):  
Bandar M Hetaimish ◽  
Eyad A Alakkas ◽  
Khalid F Alharbi ◽  
Abdulrahman M Alradadi ◽  
Habib Y Aletani ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Chronic Diseases ◽  
Hip Arthroplasty ◽  
Common Indication ◽  
Total Hip ◽  
Tertiary Center ◽  
Duration Of Surgery ◽  
Post Traumatic

Objectives: Total hip arthroplasty (THA) is one of the most effective orthopedic interventions for the treatment of patients with advanced‑ stage hip disease. However, reports regarding indications for primary THA in Saudi Arabia are limited. We aimed to evaluate primary indications for THA and identify associated chronic diseases and postoperative complications in THA patients at a tertiary hospital in Saudi Arabia. These are important to provide knowledge on types of hip diseases and variables that may affect the outcome of this intervention in the Saudi population. Methods: This is a retrospective cohort study of THA cases performed between 2010 and 2019 at a tertiary center in Saudi Arabia. Retrieved data include patients’ ages at the time of surgery, chronic diseases, presurgical diagnosis, site and duration of surgery, and postoperative complications. Results: We identified 83 patients who had undergone primary THA; in regard to comorbidities, 32.5% and 30.1% had hypertension and diabetes mellitus, respectively. The most common indication for THA was degenerative hip osteoarthritis (50.6%), followed by post-traumatic arthritis (22.9%) and hip avascular necrosis (20.5%). Conclusion: Despite the high rate of trauma and accidents in Saudi Arabia, degenerative osteoarthritis remains the most common indication for primary THA. Post-traumatic osteoarthritis is identified as the second major indication for THA.

scholarly journals Phenotypes and Genotypes of Patients with Pantothenate Kinase-Associated Neurodegeneration in Asian and Caucasian Populations: 2 Cases and Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Chih-Hong Lee ◽  
Chin-Song Lu ◽  
Wen-Li Chuang ◽  
Tu-Hsueh Yeh ◽  
Shih-Ming Jung ◽  
...  
Keyword(s):  
Literature Review ◽  
Age Of Onset ◽  
Pantothenate Kinase ◽  
Asian Patients ◽  
Truncating Mutation ◽  
Clinical Presentations ◽  
Segmental Dystonia ◽  
Generalized Dystonia ◽  
Caucasian Patients ◽  
Iron Deposits

Objectives. Pantothenate kinase-associated neurodegeneration (PKAN) is a rare disease caused by pantothenate kinase 2 (PANK2, OMIM 606157) mutations. This study is aimed to investigate clinical presentations, pathologies, and genetics in patients with PKAN.Methods. Two patients with PKAN were reported. We reviewed the literature to include additional 19 patients with PKAN in Eastern Asia. These patients were divided into classic and atypical groups by the age of onset. We compared the data on PKAN patients of Asian and Caucasian populations.Results. We found iron deposits in the globus pallidus in our Patient 1 and a heterozygous truncating mutation (c.1408insT) in Patient 2. Literature review shows that generalized dystonia and bulbar signs are more common in classic PKAN patients, whereas segmental dystonia and tremors are more specific to atypical ones. Asian patients have less complex presentations—lower prevalence of pyramidal signs, mental impairment, and parkinsonism—than Caucasians. D378G in exon 3 is the most frequent mutation (28%) in Asians.Conclusions. Our study demonstrates that the distribution of dystonia is the major distinction between subgroups of PKAN. Caucasian patients have more complex presentations than Asians. Exon 3 and 4 are hot spots for screeningPANK2mutations in Asian patients.

Nasal Anatomy and Function

2017 ◽  
Vol 33 (01) ◽  
pp. 003-008 ◽  
Author(s):  
Ruchin Patel
Keyword(s):  
Complex Structure ◽  
Respiratory Physiology ◽  
Nasal Reconstruction ◽  
Facial Aesthetics ◽  
Basic Understanding ◽  
Nasal Anatomy ◽  
And Function ◽  
Nasal Function ◽  
Nasal Defects

AbstractThe nose is a complex structure important in facial aesthetics and in respiratory physiology. Nasal defects can pose a challenge to reconstructive surgeons who must re-create nasal symmetry while maintaining nasal function. A basic understanding of the underlying nasal anatomy is thus necessary for successful nasal reconstruction.

scholarly journals Clinical study regarding nasal reconstruction methods

2015 ◽  
Vol 5 (17) ◽  
pp. 37-44
Author(s):  
Sabina Ionita ◽  
Ioan Lascar
Keyword(s):  
Clinical Study ◽  
Nasal Reconstruction ◽  
Functional Reconstruction ◽  
Reconstruction Methods ◽  
Nasal Defect ◽  
European Social Fund ◽  
Social Fund ◽  
Post Traumatic ◽  
The Difference ◽  
Dorsum Nasi

Abstract BACKGROUND. In present days, there are described many reconstruction techniques for nasal post-traumatic and post-excision total defects, from simple suture to microsurgical free transfer in nasal reconstruction. It is important to follow the defect dimensions, its topography and also its etiology. The nasal aesthetic subunits principle is very important in aesthetic and functional reconstruction of a nasal defect. MATERIAL AND METHODS. The clinical study from this paper was realised on the patients admitted in the Department of Plastic and Reconstructive Surgery of the Emergency Clinical Hospital from Bucharest, between 2012 and 2013. Different determinant factors were studied for the success of nasal reconstruction. It was compared the difference between the reconstruction of the whole nasal subunit, based on aesthetic subunits principle, and the reconstruction of the defect. RESULTS. Although in our clinic the reconstruction of the defect is used in the majority of the cases and rarely the reconstruction based on aesthetic subunits principle, very good results were obtained, with a reduced number of complication and very few relapses. CONCLUSION. The success of the reconstruction depends on multiple factors regarding the type of the defect. The grafts can give very good results in all aesthetic subunits, while the nasogenian flap has good results for the reconstruction of the nasal wing and lobule defects. The frontal flap is the first option for reconstruction of the dorsum nasi with satisfactory results. This paper is supported by the Sectoral Operational Programme Human Resources Development (SOP HRD), financed from the European Social Fund and by the Romanian Government under the contract number POSDRU/159/1.5/137390

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