1,721,146 research outputs found
Brows Asymmetry Correction With the Direct Approach: Myth or Reality?
No full textOBJECTIVES:
The current article is aimed to test the effectiveness of direct and indirect brow lifting to correct brows asymmetry.
METHODS:
Fifty patients treated with direct brow lift between January of 2011 and January of 2013 were investigated. All patients were men and treated under local anesthesia. In all patients, the brow lifting was associated with an upper blepharoplasty. The amount of brow elevation produced was assessed by comparison of the preoperative and at 1-year postoperative vertical distances between the superior eyebrow hairline and the interpupillary line at midpupil and at lateral and medial canthus. Paired sample t-test was used to investigate brow lifting amelioration after 1 year. The differences in measurements between the 2 sides were plotted to evaluate the degree of symmetry between 2 sides. In addition, a comparison was performed; a series of 45 patients treated with temporal (ie, indirect) approach.
RESULTS AND CONCLUSIONS:
The paired sample test demonstrated that direct brow lifting is a proper surgical technique to correct brow asymmetry. Also temporal (ie, indirect) approach is able to ameliorate brow asymmetry but direct technique provide better results. The direct brow lifting is a reliable, reproducible and safe surgical procedure, provides excellent and long-lasting results, and is very efficacious in brows asymmetry correction
Comparison among three different fixation techniques in temporal brow lift surgery
No full textIntroduction: The eyebrow lifting with temporal approach is an increasing widespread technique. Many surgical procedures are described, but the long-term stability is dependent on the effectiveness in the fixation of elevated tissues. The authors compared 3 different fixation techniques in temporal brow lift.
Methods: Forty-five consecutive patients aged between 33 and 70 underwent brow lift surgery with temporal approach. Patients were divided into 3 groups; in group 1, anchorage was performed with Endotine Ribbon, group 2 with a Mersilene mesh, and group 3 with a Prolene suture. The amount of brow elevation was assessed comparing the distance between interpupillar line and superior eyebrow hairline, measured at the midpupil and at the lateral and medial canthal angle. The follow-up was 1 year.
Results: All patients had a pleasant improvement in brow shape. The average initial brow position was 19.84 mm near the head of the eyebrow area, 20.74 mm at the body, and 19.57 mm in the region of the tail. A progressive recovery and a partial relapse regarding the eyebrow body (23.88 mm at 6 months and 23.02 mm at 1 year) occurred, but overall for the lateral region, it passed from 27.53 mm at 6 months to 25.80 mm after a 12-month follow-up. Final brow position was dependent upon surgical technique used in fixation.
Discussion: Different options in brow elevation and stabilization affect the final shape and position of the brows. From the statistical analysis, mesh suspension provided the best results in terms of long-lasting stability.
Level of evidence: Therapeutic II
Treatment of the Crooked Nose: The Final Steps to Perfection
No full textPerfection is sometimes approached in treatment of the crooked nose today but not fully achieved due to the continued existence of flaws. While the traditional surgical algorithm envisages the use of 2 series of procedures to straighten the nasal bones and cartilaginous septum, the addition of a third appears very useful with a view to obtaining truly excellent results, above all in the case of marked deviation. The authors present their experience in the use of certain procedures designed to correct asymmetry of the upper lateral and lower lateral cartilages, as well as the soft covering tissues where necessary.A retrospective study was carried out on 105 patients treated for crooked nose over a 3-year period, 90% of the patients being due to trauma and the remaining 10% to congenital malformation. All the patients involved severe deviation of the nasal pyramid.The mean follow-up period was 18 months (range: 8-36 months). The use of these additional surgical procedures made it possible to obtain excellent final results in 83 (97.6%) patients with crooked nose of traumatic origin and in 17 (85%) patients with crooked nose due to congenital malformation. No major complication was registered, although 3 patients did present minor complications not connected with the nasal deviation.In conclusion, more modern approach to correction of the crooked nose should involve not only realignment of the osteocartilaginous axis but also treatment of the neighboring structures
Tarsal sling: an essential stitch to prevent scleral show in lower blepharoplasty
No full textBACKGROUND:
Despite its popularity for facial rejuvenation, blepharoplasty has been associated with several adverse effects. One of the most common is eyelid displacement after lower transcutaneous blepharoplasty. The tarsal sling procedure affixes the external portion of the septum (the lateral canthal ligament) to the internal orbital wall periosteum with a simple suture. This simplified canthopexy decreases the risk of lower eyelid margin displacement.
OBJECTIVES:
The authors sought to determine the effectiveness of the tarsal sling technique in preventing lower eyelid malposition.
METHODS:
A retrospective analysis of 40 consecutive patients was conducted. Twenty patients underwent standard blepharoplasty (group 1), and 20 underwent blepharoplasty plus tarsal sling support (group 2). Pre- and postsurgical positions of the lower eyelid margin were compared by quantitative analysis of measurements obtained from clinical photographs.
RESULTS:
Postoperatively, reduction of scleral appearance was noted for group 2. Although progressive recovery occurred in this group by 2 years postoperative, the lower eyelids did not revert to presurgical position, and a slight degree of overcorrection remained. The overcorrection was minimal, without unpleasant consequences for the patients. In contrast, group 1 patients experienced an increase in the distance between the interpupillary line and the lateral aspect of the lower eyelid margin after blepharoplasty. Although progressive resolution of scleral show occurred by 2 years postoperative, recovery was not complete.
CONCLUSIONS:
Through quantitative analysis, the authors demonstrated the effectiveness of a simplified canthopexy procedure. Tarsal sling is an easy, quick, and efficacious procedure to prevent eyelid malposition after lower blepharoplasty
Lateral Canthal Support in Prevention of Lower Eyelid Malpositioning in Blepharoplasty
No full textLower blepharoplasty is a cornerstone in facial rejuvenation and improvement. Despite its popularity, several adverse effects have been described; of these, postsurgical eyelid displacement, with its aesthetic and functional consequences, is one of the more frequent complications. The tarsal sling procedure is a simplified canthopexy consisting in the fixation of the lateral portion of the septum--the canthal ligament--to the orbital wall periosteum. The aim of the current research is to demonstrate how the tarsal sling technique is effective in the prevention of lower lid malpositioning. A retrospective analysis of 40 consecutive healthy individuals was carried out. In group 1, 20 patients underwent standard blepharoplasty; in group 2, blepharoplasty was associated to the tarsal sling canthopexy. Pre- and postsurgical position of the lower eyelid margin was compared through photographic measurements at 5 time points and statistical analysis performed. Group 1 patients evidenced an increased distance between the interpupillary line and the lateral aspect of the lower lid margin. A progressive spontaneous improvement (reduction in scleral exposition) was detected. Patients who underwent the tarsal sling procedure (group 2) reported a postoperative overcorrection of scleral appearance. Two years postsurgery, progressive relapse occurred, but the lower eyelid did not reach presurgical values and maintained a slight degree of overcorrection. Tarsal sling is an easy, fast, and efficacious procedure to prevent eyelid displacement in lower blepharoplasty. Its routine use is a tool to assure further support to lower lids in the younger patients or when lid laxity is absent during presurgical examination
Secondary breast reconstruction in small to medium-sized irradiated breasts: could Fat-Augmented LD (FALD) flap be a reliable alternative?
No full textBackground: Secondary breast reconstruction (BR) is recognized as a challenging procedure, particularly when radiotherapy (RT) has previously been performed. The aim of this study was to compare operative data and aesthetic outcomes between secondary irradiated and immediate BR using the fat-augmented latissimus dorsi (FALD) flap. Methods: The authors conducted a prospective clinical study between September of 2020 and September of 2021. Patients were divided into two groups: group A included secondary BR using the FALD flap in previously irradiated breasts, and group B included immediate BR with the FALD flap. Demographics and surgical data were compared, and an aesthetic analysis was performed. Chi-square and t tests were performed for categorical and continuous variables, respectively. Results: Twenty cases of FALD flap-based BR for each group were included. The two groups were found to be homogeneous for the demographic variables. The difference in mean operative time (263.1 minutes versus 265.1 minutes; P = 0.467) and complications ( P = 0.633) between the two groups were not significant. There was statistically significant difference in term of immediate fat grafting volume in favor of group A (218.2 cc versus 133.0 cc; P < 0.0001). Regarding aesthetic outcomes, the mean global score evaluation showed no statistically significant differences between groups (17.86 versus 18.21; P = 0.209). Conclusions: The authors' study states that the FALD flap can be considered a reliable procedure for secondary reconstruction in previously irradiated breasts, although it is not indicated for patients with larger breasts. This surgical technique allowed us to achieve a totally autologous BR with good aesthetic results and low complication rates, even in secondary irradiated cases. Clinical question/level of evidence: Therapeutic, II
Correction to: The Medical Historical Cultural Foundations of Western Nasal Surgery from Ancient Greece to the Middle Ages
Full text linkThis article was updated to correct the inversion of the authors’ given and family names
The medical historical cultural foundations of western nasal surgery from ancient greece to the middle ages
Full text linkThe manuscript aims to clarify the origins of Western rhinosurgery through the ancient texts of the greatest physicians of the past, up to the Byzantine Era, focusing on the "exchange of knowledge" between peoples. This excursus is carried out by quoting the texts of the greatest doctors of the past, such as Hippocrates, Galen and Celsus and by analysing the works of Byzantine authors such as Oribasius, Aetius, Antillus, which, more than others, represent the moment of fusion and interpenetration of Ancient Medical knowledge, paving the way for the Medieval Scholae Medicae in the West. The aim, therefore, is to fill that sort of "great gap" (from the foundation of Constantinople in the 4th century AD to the early Arab culture in the 11th century AD) due to the fact that figures such as Branca, Vianeo and, finally, Tagliacozzi, are considered direct actors of a recovery of the "ancient knowledge" of classic authors. This literature tends to less evaluate, instead, that important and huge cultural exchange -literally osmotic- in medical and surgical knowledge between peoples and civilizations, that find a trait d'union in the application of medical knowledge and surgical practical techniques matured in the Byzantine, Arab and Early Medieval period. In final analysis, through the History of Rhinosurgery, this paper aims to highlight how Western medical knowledge is made up of the ensemble of cultures which are apparently distant and different from each other, which merge themselves in a truly universal and transcultural knowledge: the Medical knowledge
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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