The advent of free tissue transfer has provided multiple options that allow preservation and maintain both the structural and aesthetic status of the scalp. Since the first report of the anterolateral thigh flap in 1984, it has become one of the most commonly used flaps for the reconstruction of various soft-tissue defects. Eleven free anterolateral thigh flaps were used to reconstruct soft-tissue defects of different regions of the scalp. Two of these flaps were used for the occipital region, six for temporal regions, two for the frontoparietal midline region, and the remaining flap for a defect of the forehead. The study consisted of 10 males and one female whose ages ranged from 18 to 82 years (mean age: 52.5 years). Six patients had primary or recurrent cancer, four had acute or subacute wounds resulting from trauma or craniotomy, and one had high-tension electrical burn injury. The size of the flaps ranged from 14 to 27 cm in length and from 6 to 18 cm in width. The overall flap success rate was 100%. In two cases, primary thinning of the flap was performed to reconstruct a tissue defect of the temporal region in one patient and a forehead defect in the other. In two patients, the fascial layer of the flap was used as a source for a vascularized fascial flap to cover defects of the dura mater. No secondary corrections, including debulking procedures or scar revision, were necessary. No infections or hematomas were observed. Six cases underwent split-thickness skin grafting of the donor site and, in the remaining cases, the donor sites were closed directly. No donor-site morbidity was observed. The authors conclude that with its evident structural and cosmetic advantages, the anterolateral thigh flap can be considered an excellent flap option for most scalp defects.
The results of this reconstructive option were satisfactory in terms of motor function and sensitive assessment of the neotongue. This technique is strongly recommended for patients with total or subtotal glossectomy.
Reactive oxygen metabolites are products of oxidative metabolism that are continuously generated in vivo, and are known to produce serious cellular, tissue and genomic damage. l-carnitine is an endogenous amine that has been shown to have an effect on the synthesis of reactive oxygen metabolites. Twenty Wistar rats, 24 months of age, were randomly assigned to two groups as control and l-carnitine treatment groups. One millilitre of distilled water was administered to control rats and 50 mg/kg l-carnitine to rats of l-carnitine treatment groups by intragastric gavage once a day for 30 days. At the end of 30 days, all groups underwent auditory brainstem response testing after administration of intraperitoneal urethane anaesthesia. l-carnitine treatment reduced III, V latencies and I-III, III-V and I-V interpeak latencies (IPL) significantly compared with the control group. l-carnitine treatment improved age-related deterioration in auditory pathways and hence may be a new alternative for the treatment of presbyacusis.
The efficiency of steroid treatment in patients with severe hearing loss was low. It was statistically ascertained that adding hyperbaric oxygen or ozone therapy to the treatment contributed significantly to treatment success.
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