1,720,993 research outputs found
Scrotal dartos-fascio-myo-cutaneous flaps for penis elongation after catastrophic iatrogenic skin shaft sub-amputation: A case of recovery using an extremely adaptable flap
No full textAbstractIntroductionGenitalia are linked to self-esteem and male sexual identity, especially among young men, who sometimes require a surgical procedure to acquire more confidence. Among the surgical procedures requested for aesthetical purposes, circumcision is one of the most popular. Although it can be considered to be a simple surgical practice, it may cause severe complications such as penile skin necrosis.Presentation of caseWe report a case of a catastrophic situation after a circumcision performed on a 27-year-old HIV positive man resulted in a drastic reduction in the length of the penile shaft due to extensive skin loss; this was subsequently restored using dartos-fascio-myo-cutaneous flaps. Primary healing occurred in 10days. No infection, dehiscence or flap ischemia were reported. Donor site morbidity was minimal. An adequate aesthetical appearance and satisfactory functional results were obtained.Discussion and conclusionVarious techniques are available for penile skin covering, such as skin grafts or cutaneous flaps. The skin of the scrotum seems to be the most suitable tissue to be used to reconstruct the skin covering of the shaft as it is the most similar. Dartos-fascio-myo-cutaneous flap is a single stage procedure that is easy and safe to perform. It can provide satisfactory cosmetic and functional results, offering a large amount of tissue, with minimal donor site morbidity
Effects of orbicularis oculi flap anchorage on the lower eyelid position in trans-cutaneous blepharoplasty. Statistical analysis of clinical outcome
No full textBackground: The aging process affects skin, muscle, fat of the eyes in a different manner. Their individual rejuvenation would require specific surgical treatment according to their particular
demands. The authors analyzed the effect of an orbicularis oculi muscle flap fixed to the superior orbital rim to prevent lower eyelid dislocation during transcutaneous blepharoplasty.
Methods: The study was conducted retrospectively comparing pre and post op images of two different groups of patients: group A (20 patients) treated with orbicularis oculi flap and group B
(17 patients) without. Pre and post op distance between the center of the pupil and the upper border of the lower lid at the middle pupil line was measured in each photo and then compared
and statistically analyzed.
Results: The mean age of the 37 patients was 57 years old. From the estimated Linear Mixed Model, we observe a significant effect of the presence of the flap (p-value < 0.0001). All the
patients treated with the orbicularis oculi flap (group A) showed a cranial movement of the lower eyelid, even though minimally. All patients treated without muscle flap (Group B) showed a caudal movement of the lower eyelid. The 47% of eyes in group B showed a positive variation greater than 10 %.
Conclusion: The study suggests that the anchorage of the orbicularis muscle flap to the upper orbital rim reinforces the lower eyelid’s anterior lamellae. It works efficiently to stabilize lower
eyelid position after transcutaneous blepharoplasty confirming clinical results, improving surgical outcomes even in patients with minimal or no eyelid laxity
The role of ultrasonography for assessment of pseudotumor cerebri syndrome in the emergency department
No full textPseudotumor cerebri syndrome (PTCS) is a condition of still obscure etiology, characterized by elevated cerebrospinal fluid (CSF) pressure but no detectable intracranial CSF compositional anomalies or abnormalities of the brain parenchyma. This syndrome generally affects adult obese individuals, especially females, but it has been frequently described also in the pediatric population. Pediatric PTCS has been reported in association with secondary factors (e.g., medical illness, infections, endocrine disturbances, drug intoxication) that seem to augment intracranial pressure in a still unexplained way. Clinical signs and symptoms of PTCS in children include headache and papilledema at the funduscopic examination. The diagnosis of PTCS in children and adults usually involves brain imaging to exclude intracranial mass and/or vascular anomalies; the lumbar puncture is also crucial to confirming elevated CSF pressure
(>250 mmH2O) and, lately, normal CSF contents at the chemical-physical examination. In recent years, ultrasonography has acquired an emerging role in the initial assessment of patient suspected to have PTCS. In fact, ocular ultrasounds allow the detection of optic disc swelling, suggestive of papilledema; additionally, ultrasonography allows the measurement of the retrobulbar optic nerve sheath diameter, which has been proposed as a noninvasive (indirect) method to assess the intracranial pressure. Ultrasound examination of the optic disc may therefore represent an important adjunct to funduscopic examination when assessing children with headache and/or visual disturbances, especially in the setting of the emergency department. We briefly discuss the application of ultrasonography in the assessment of pediatric patients with PTCS
Evaluation of Residual Neuro-Muscular Integrity in the Orbicularis Oculi Muscle After Lower Eyelid Transcutaneous Blepharoplasty According to Reidy Adamson-s Flap
No full textBackground The aging process affects skin, muscle and fat of the eyes in a different manner. Their individual rejuvenation would require specific surgical treatment according to their particular demands during lower eyelid blepharoplasty. This would require the separate management of the skin and the muscle by separating them into two different flaps. Basing on the anatomy, during subciliary myocutaneous incision in conventional lower eyelid
transcutaneous blepharoplasty most of innervations of the lower orbicularis oculi muscle are transected and denervation sequelae at the pretarsal orbicularis oculi muscle would be expected. However, sub/ciliary approach is still
popular. The absence of signs or symptom of denervation of in our large case series even though injury to the motor innervation of the orbicularis oculi muscle during the operation led the authors to investigate the discrepancy
between the anatomical concept and clinical outcomes. The study aimed to investigate the residual functionality of the orbicularis oculi muscle after lower eyelid transcutaneous blepharoplasty according to Reidy Adamson-s flap.
Materials and Methods Ten patients were enrolled in the study. Orbicularis oculi muscle functionality was investigated with electroneurography before and at least 6 months after the surgical procedure. Investigated parameters are: Compound Muscle Action Potential (CMAP) as expressions f quantity of activated muscular fibers by the electrical stimulation of the facial nerve. Pre- and post-op collected data were compared and statistically analyzed.
Results The mean age was 52.9; minimum follow-up 6 months; twenty eyes were investigated; 1 patient was excluded. Postoperative data did not show any significant reduction in the CMAP at all. Conclusion The study suggests that the buccal branch and medial branch of the zygomatic nerve of the facial nerve supplies efficiently to the orbicularis oculi innervation
Re: “Blepharoplasty Effect on a Described Algorithmic Approach to External Ptosis Repair: Is It Time for Unbundling?”
No full textBlepharoplasty Effect on a Described Algorithmic Approach to External Ptosis Repair: Is It Time for Unbundling
Discussion: “Long-Term Follow-Up of Recurrence and Patient Satisfaction After Surgical Treatment of Gynecomastia”
No full textDiscussion: "Long-Term Follow-Up of Recurrence and Patient Satisfaction After Surgical Treatment of Gynecomastia"
Evidence-Based Medicine: A Graded Approach to Lower Lid Blepharoplasty
No full textEvidence-Based Medicine: A Graded Approach to Lower Lid Blepharoplasty
Experience of Immediate Ambulation and Early Discharge After Tumescent Anesthesia and Propofol Infusion in Cosmetic Breast Augmentation
No full textExperience of Immediate Ambulation and Early Discharge After Tumescent Anesthesia and Propofol Infusion in Cosmetic Breast Augmentation
Comment to “Transconjunctival Orbital Septum Fat Release and Preservation for Orbitopalpebral Sulcus in Lower Eyelid Blepharoplasty”
No full textComment to "Transconjunctival Orbital Septum Fat Release and Preservation for Orbitopalpebral Sulcus in Lower Eyelid Blepharoplasty"
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