5,026 research outputs found
Algorithm for clinical evaluation and surgical treatment of gynaecomastia.
No full textAlgorithm for clinical evaluation and surgical treatment of gynaecomastia.
Cordova A, Moschella F.
Source
Dipartimento di Discipline Chirurgiche ed Oncologiche, Cattedra di Chirurgia Plastica e Ricostruttiva, Università degli Studi di Palermo, Palermo, Italy. [email protected]
Abstract
BACKGROUND:
Gynaecomastia can be classified on the basis of the main characterising factors, i.e. pathogenesis, histopathology and morphology. The morphological classifications of gynaecomastia currently made often use subjective parameters and qualifying adjectives. In this paper the authors propose a scheme for morphological classification of gynaecomastia which can serve as a guide for choosing the surgical technique, once the diagnosis of gynaecomastia as a benign pathology has been confirmed by preoperative examinations.
METHODS:
A retrospective analysis was made of 121 cases of gynaecomastia operated on in the last 5 years. The extent of the clinical picture, the technique employed, the complications and the need to re-operate were observed and related.
RESULTS:
On the basis of this review the authors observed that when the nipple-areola complex is above the inframammary fold (grade I and grade II gynaecomastia), complete flattening of the thorax can be achieved by means of suction or ultrasound-assisted lipectomy and skin-sparing adenectomy. When the nipple-areola complex is at the same height as, or at most 1cm below the fold (grade III gynaecomastia), skin-sparing techniques are no longer sufficient to flatten the thorax, and it becomes necessary to remove the redundant skin by means of periareolar removal of epidermis. In cases of marked ptosis, when the nipple-areola complex is more than 1cm below the fold (grade IV gynaecomastia), reduction mastoplasty becomes necessary, with upper repositioning of the nipple-areola complex; in these cases central pedicle techniques make it possible to limit scarring in the periareolar areas.
CONCLUSIONS:
In the preoperative phase this simple classification may help in choosing the most suitable treatment, thus avoiding insufficient or invasive treatments and undesirable scars
The "Jacobsen flap" technique: a safe, simple surgical procedure to treat Dupuytren disease of the little finger in advanced stage.
No full textThe "Jacobsen flap" technique: a safe, simple surgical procedure to treat Dupuytren disease of the little finger in advanced stage.
Tripoli M, Cordova A, Moschella F.
Source
Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Università degli Studi di Palermo, Italy. [email protected]
Abstract
The surgery for advanced stages of Dupuytren disease of the little finger is controversial. In the literature, several techniques have been described with variable reported results and postoperative complications. Percutaneous needle fasciotomy, McCash technique, and dermofasciectomy are often performed for surgical treatment but they present significant complications and limits. This study reviews our experience of using the Jacobsen flap technique, a modification of the McCash procedure. We found that the Jacobsen flap technique for the significant correction of the contracture, the low rate of complications, and the relatively simple surgical approach is an excellent alternative to percutaneous needle fasciotomy, dermofasciectomy, or amputation
STATIC TREATMENT OF PARALYTIC LAGOPHTALMOS WITH AUTOGENOUS TISSUES
No full textStatic treatment of paralytic lagophthalmos with autogenous tissues.
Pirrello R, D'Arpa S, Moschella F.
Source
Cattedra di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Universitá di Palermo, Via del Vespro, 129, 90138 Palermo, Italy.
Abstract
BACKGROUND:
Long-standing facial paralysis is frequently seen in patients who have undergone surgical procedures with sacrifice of the facial nerve and have never been counseled about limiting its consequences. Lagophthalmos must always be treated in these patients to protect vision. The authors describe their techniques of static treatment for lagophthalmos using autologous tissues and their classification system for standardizing patients.
METHODS:
From July 2001 to September 2005, 12 patients (9 men and 2 women) ranging in age from 37 to 77 years (mean, 58.5 years) were treated. Their paralysis was attributable to acoustic neuroma resection in seven cases, to resection of a cerebral vascular anomaly in two cases, and to total parotidectomy with facial nerve sacrifice in three cases. The patients were treated with elongation of the levator palpebrae superioris muscle using a fascia lata graft, bolstering of the lower eyelid with a conchal cartilage graft, or both, combined with a Kuhnt type resection when needed.
RESULTS:
Complete closure was achieved for nine patients (75%). For all the patients, resolution of symptoms and keratitis was achieved. No complications were observed. The follow-up period ranged from 14 to 51 months (mean, 39.5 months). The cosmetic outcome also was satisfactory.
CONCLUSIONS:
For candidates eligible to undergo static treatment of lagphthalmos, the techniques described may be considered valuable options for the correction of lagophthalmos using autologous tissues, thus avoiding the complications related to alloplastic material implantatio
Analogue gravity phenomenology: analogue spacetimes and horizons, from theory to experiment
No full textAnalogue Gravity Phenomenology is a collection of contributions that cover a vast range of areas in physics, ranging from surface wave propagation in fluids to nonlinear optics. The underlying common aspect of all these topics, and hence the main focus and perspective from which they are explained here, is the attempt to develop analogue models for gravitational systems. The original and main motivation of the field is the verification and study of Hawking radiation from a horizon: the enabling feature is the possibility to generate horizons in the laboratory with a wide range of physical systems that involve a flow of one kind or another. The years around 2010 and onwards witnessed a sudden surge of experimental activity in this expanding field of research. However, building an expertise in analogue gravity requires the researcher to be equipped with a rather broad range of knowledge and interests. The aim of this book is to bring the reader up to date with the latest developments and provide the basic background required in order to appreciate the goals, difficulties, and success stories in the field of analogue gravity.
Each chapter of the book treats a different topic explained in detail by the major experts for each specific discipline. The first chapters give an overview of black hole spacetimes and Hawking radiation before moving on to describe the large variety of analogue spacetimes that have been proposed and are currently under investigation. This introductory part is then followed by an in-depth description of what are currently the three most promising analogue spacetime settings, namely surface waves in flowing fluids, acoustic oscillations in Bose-Einstein condensates and electromagnetic waves in nonlinear optics. Both theory and experimental endeavours are explained in detail. The final chapters refer to other aspects of analogue gravity beyond the study of Hawking radiation, such as Lorentz invariance violations and Brownian motion in curved spacetimes, before concluding with a return to the origins of the field and a description of the available observational evidence for horizons in astrophysical black holes
EVOLUZIONE DELLE TECNICHE DI RICOSTRUZIONE MORFODINAMICA NEI CARCINOMI DELL'AREA LABIALE
No full textUtilizzazione del lembo muscolo-cutaneo di obliquo esterno nella ricostruzione della parete toracica dopo mastectomia allargata
No full text
Superior pedicle retroauricular island flap for ear and temporal region reconstruction: anatomic investigation and 52 cases series.
No full textSuperior pedicle retroauricular island flap for ear and temporal region reconstruction: anatomic investigation and 52 cases series.
Cordova A, Pirrello R, D'Arpa S, Moschella F.
Source
Cattedra di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Università degli Studi di Palermo, Palermo, Italy. [email protected]
Abstract
BACKGROUND:
On the basis of a previously published anatomic study on the superior auricular artery (SAA) and on a series of 52 consecutive cases, the authors propose a new superior pedicle retroauricular island flap (SP-RIF) for defects of the upper half of the ear and for temporal region or superficial helical defects.
METHODS:
Twenty five auricular regions were dissected after colored latex injection in the carotid artery of 13 fresh cadavers to investigate the SAA. A SP-RIF was used in 52 consecutive cases after tumor excision. In 51 cases, the defect involved the upper half of the ear. In one case, the defect was in the temporal region.
RESULTS:
The SAA originates either from the superficial temporal artery (44%) or from its parietal branch (56%). Length, caliber, and course have been assessed. Esthetic results of the reconstruction were excellent. There were no major complications in this series. No sequelae at the donor site were recorded.
CONCLUSIONS:
The SP-RIF can be considered as a first choice option to repair nonmarginal losses of substance of the upper half of the ear. Because of its wide arc of rotation, it can also be used for superficial marginal defects of the helix and in selected cases of temporal region defect
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