Background Supratip depression is a common complication after preservation rhinoplasty. Objectives This paper presents a simple surgical maneuver to prevent supratip depression. Methods Thirty-six patients who underwent closed-approach low-septal-resection dorsal preservation rhinoplasty between January and June 2021 were included in this retrospective study. Depending on the operation performed on Pitanguy’s midline ligament, the patients were divided into two main groups as follows: (1) a group in which Pitanguy’s midline ligament was transected (the transection group), and (2) a group in which Pitanguy’s midline ligament was preserved (the preservation group). Standardized postoperative 6-month lateral-view photographs were scanned for the presence of supratip depression or pollybeak deformity. The Rhinoplasty Outcome Evaluation (ROE) scale was applied at 6 months. Results Supratip depression was observed in four patients in the preservation group (n = 16), and it was not observed in any of the patients in the transection group (n = 20; p < 0.05). There was no pollybeak deformity in either group. For the ROE scores and number of satisfied patients, no statistically significant difference was found between the groups with Pitanguy’s midline ligament transected versus preserved (p > 0.05). Conclusions Transecting Pitanguy’s midline ligament reduces the likelihood of supratip depression and does not affect the likelihood of pollybeak deformity in closed-approach low-septal-resection dorsal preservation rhinoplasty.
BackgroundXeroderma pigmentosum (XP) is an autosomal recessive disorder characterized by xerosis, ultraviolet light sensitivity, and cutaneous dyspigmentation. Due to defects in their DNA repair mechanism, genetic mutations and carcinogenesis inevitably occurs in almost all patients. In these patients, reconstruction of cutaneous malignancies in the head and neck area is associated with some challenges such as likelihood of recurrence and an aggressive clinical course. The aim of this study is to discuss the therapeutic options and challenges commonly seen during the course of treatment.MethodsBetween 2005 and 2015, 11 XP patients with head and neck cutaneous malignancies were included in this study. Demographic data and treatment options of the patients were evaluated.ResultsThe mean age of the patients was 32 years (range, 10–43) (4 males, 7 females). The most common tumor type and location were squamous cell carcinoma (6 patients) and the orbital region (4 patients), respectively. Free tissue transfer was the most commonly performed surgical intervention (4 patients). The average number of surgical procedures was 5.5 (range, 1–25). Six patients were siblings with each other, 5 patients had local recurrences, and one patient was lost to follow-up.ConclusionsAlthough genetic components of the disease have been elucidated, there is no definitive treatment algorithm. Early surgical intervention and close follow-up are the gold standard modalities due to the tendency toward rapid tumor growth and possible recurrence. Treatment must be individualized for each patient. In addition, the psychological aspect of the disease is an important issue for both patients and families.
BackgroundThe aim of this study was to evaluate peripheral nervous system involvement and prevalence of neuropathic pain in ankylosing spondylitis (AS).ObjectivesThe aim of this study was to evaluate peripheral nervous system involvement in ankylosing spondylitis (AS). Nerve conduction methods that were not previously used in other studies (i.e. superficial peroneal nerve (MDSP) sensory conduction studies, F-wave responses, soleus H reflex responses) were used to define peripheral neuropathy in patients with AS. Clinical evaluation was also integrated to show pathologies of peripheral nervous system and to interpret the presence of neuropathic painMethodsFifty-three AS patients and 40 healthy controls were enrolled in this study. On physical examination of the patients;Schober, hand-floor distance, occiput-wall distance, and chest expansion were evaluated. Visual analogue scale (VAS) for pain, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASM) was used. In all cases, quality of life was assessed by Short Form-36 (SF-36) and neuropathy was evaluated with neurological examination, clinical neuropathy classification and Leeds Assessment of Neuropathic Symptoms Score (LANSS). In all cases, electrophysiological examination included dominant hand median, ulnar, bilateral tibial and peroneal motor nerve conduction studies; dominant hand median, ulnar, radial, and bilateral sural and superficial peroneal sensory nerve conduction studies along with the dominant hand median, bilateral tibial F waves, and bilateral soleus H-reflex latencies.ResultsIn this study, clinical peripheral neuropathy (PNP) was found in 6 (11.3%) AS patients using clinical neuropathy classification.Thirty-three patients (62%)had neuropathic pain symptoms. LANSS score of patients was significantly higher than control group (p<0.01). In the electrophysiological examination of the patient group, there was carpal tunnel syndrome (CTS) in 5 patients, ulnar neuropathy (UN) in 2 patients, sensory PNP in 5 patients and sensorymotor PNP in 5 patients; a total of 17 patients (32.1%) were affected. In the asymptomatic healthy control group, 2 (5%) showed UN. In the patient group, the distal latencies in all the motor nerve conduction studies were longer than the control group (p<0.05, p<0.01). All sensory nerve conduction velocities were slower, and the distal latencies were longer than those of the control group, respectively. F-wave latencies and H-reflex latencies showed no significant differences between the groups (p 0.05).ConclusionsPeripheral neuropathy is seen more frequently in patients with AS than the normal population.In our study, incidence of PNP is higher than other studies without MDSP nerve conduction study in patients with AS. The reason of this result could be due to MDSP nerve testing in this study, which is a more sensitive test of nerve conduction studies.Although F-wave latencies and the H-reflex responses have not turned out to be significant in our study and the presence of the MDSP...
Background: Erythropoietin has neuroregenerative effects. Fibrin glue may be used for nerve repair and controlled release of substances. In this study, the authors investigated the effects of erythropoietin-containing fibrin glue on nerve repair, based on the hypothesis that erythropoietin-containing fibrin glue would positively affect nerve regeneration. Methods: Thirty-six Long-Evans rats were used. The animals were divided into six groups. Their left sciatic nerves were isolated, transected, and repaired with saline-containing fibrin glue in group 1, with erythropoietin-containing fibrin glue in group 2, with saline-containing fibrin glue and two sutures in group 3, with erythropoietin-containing fibrin glue and two sutures in group 4, with two sutures in group 5, and with four sutures in group 6. Sciatic Functional Index calculation, pin-prick test, and toe-spread test were performed on days 21, 42, and 63. All animals were killed on day 63. The nerve sections were analyzed histologically. Results: The Sciatic Functional Index, pin-prick test, and toe-spread test results were the best in group 4 and the worst in group 5. Group 4 showed superior Schwann cell proliferation (p < 0.05). Groups with epineural suture use (groups 3, 4, 5, and 6) had higher endoneurial collagen synthesis scores than the groups without suture use (groups 1 and 2) (p < 0.05). The myelin protein zero immunostaining results were significantly higher in the erythropoietintreated groups (groups 2 and 4) (p < 0.05). Conclusion:The combined use of erythropoietin-containing fibrin glue and two epineural sutures (group 4) showed a statistically significant improvement in many parameters. (Plast. Reconstr. Surg. 149: 395, 2022.) Clinical Relevance Statement: Fibrin glue is already used in nerve repair. Adding erythropoietin to fibrin glue could be a safe and easy option to improve nerve regeneration.
lthough every anatomical subunit is important in rhinoplasty, the nasal tip is crucial for successful results. The tip is the area that changes most in the postoperative period compared to other parts of the nose, such as the radix or dorsum. Decrease in tip projection, tip dropping, and hanging columella are the most common undesirable changes in the postoperative period. Various tip and medial crura stabilization and strengthening techniques are used to deal with these changes. Columellar strut graft placement and tongue-in-groove suturing are the most commonly used techniques. The columellar strut technique was described much earlier than
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