The alveolar cleft has not received as much attention as labial or palatal clefts, and the management of this cleft remains controversial. The management of alveolar cleft is varied, according to the timing of operation, surgical approach, and the choice of graft material. Gingivoperiosteoplasty does not yet have a clear concensus among surgeons. Primary bone graft is associated with maxillary retrusion, and because of this, secondary bone graft is the most widely adopted. However, a number of surgeons employ presurgical palatal appliance prior to primary alveolar bone graft and have found ways to minimize flap dissection, which is reported to decrease the rate of facial growth attenuation and crossbite. In this article, the authors wish to review the literature regarding various advantages and disadvantages of these approaches.
Penoscrotal defects are associated with a variety of conditions, including extramammary Paget disease (EMPD), Fournier's gangrene (FG), and skin cancer. Careful reconstruction of the penoscrotal region is vital for sexual and urological functions [1]. The aims of reconstruction are to assist wound healing and provide adequate function and acceptable appearance. However, reconstruction of penoscrotal defects is difficult because of the variety of skin colors and thicknesses, the presence of bacterial flora, difficulty in immobilization, and complicated contours [1]. Therefore, a variety of approaches must be used for reconstruction, which are based on the size, position, and severity of the defect and the availability of surrounding tissue.We reconstructed penoscrotal defects using local advancement scrotal flaps, skin grafting, anterolateral thigh (ALT) flaps, and internal pudendal artery perforator (IPAP) flaps and obtained satisfactory results. The purpose of the study was to review and analyze the results of our patients who underwent reconstruction of penile and scrotal defects. AbstractBackground: Penoscrotal defects are associated with a variety of conditions, including extramammary Paget disease, Fournier's gangrene, and skin cancer. Careful reconstruction of the penoscrotal region is vital for sexual and urological functions. We used a variety of methods to reconstruct penoscrotal defects and obtained satisfactory results. Methods: We performed a retrospective chart review of 13 patients who underwent penoscrotal reconstruction from January 2012 to May 2016. All patients underwent radical debridement. The defect sizes ranged from 4 to 225 cm 2 (mean 75.0 cm 2 ). The reconstructive procedures were performed using split-thickness skin grafts (STSGs) and scrotal advancement, pedicled anterolateral thigh (ALT), and internal pudendal artery perforator (IPAP) flaps. Results: All of the flaps survived, with no reports of total flap necrosis or congestion. The overall surgical complication rate was 23.1%. A hematoma occurred in 1 patient and wound dehiscence occurred in 2 patients; the problems resolved after a minor surgical procedure. Conclusion: The selection of an appropriate reconstruction method should be based on the size, location, and severity of the defect in addition to the availability of local tissue. A skin graft is recommended for defects of the penile shaft. A scrotal flap is appropriate for the reconstruction of small scrotal defects, whereas the pedicled ALT flap and IPAP flap are recommended for large defects. We have proposed a flowchart for the reconstruction of penoscrotal defects that is based on the characteristics of the defects and our clinical experience.
A nasal bone fracture is one of the most common facial injuries and is often treated by closed reduction. Typically, 2 to 3 weeks are needed for patients to return to daily life because the operation is performed after swelling around the fracture site is reduced. This study aimed to investigate that hyaluronidase injection could reduce swelling, perform early operation and return to daily life accelerated. From January 2017 to December 2017, 181 patients with nasal bone fracture were analyzed. 60 patients underwent hyaluronidase injection and massage to reduce edema, then performed surgery within 2 to 4 days. The remaining patients were treated conservatively (massage alone); they then underwent surgery. Ultrasonography was used to measure changes in skin thickness, and the treatment duration, outcome, and patient satisfaction were compared. The duration from injury to surgery was short in the early operation group, and the period of recovery and return to ordinary life was significantly shorter than in the conventional group. The difference in skin thickness after hyaluronidase injection and massage was 0.8鈥妋m in the early operation group; there was no significant difference in the conventional group. There was no statistically significant difference in satisfaction between the 2 groups, but the mean satisfaction was higher in the early operation group. In patients with nasal bone fracture after facial trauma, hyaluronidase injection, and massage led to reduced edema. This might improve patient satisfaction by allowing earlier operation and earlier return to daily life.
The optimal treatment modalities are determined based on the symptoms and degree of the bone defects in patients with medial orbital wall blowout fracture. Most of the patients in this series underwent implant surgery. However, there are many patients whose implants were not fixed during surgery. Therefore, some patients who had implant migration occurred had been reported. We have therefore used methods for applying fibrin glue (Tisseel, Baxter Healthcare, Norfolk, United Kingdom) for the fixation of implant. Between 2007 and 2013, a total of 168 patients underwent porous polyethylene orbital implant (Medpor) surgery with the application of Tisseel. All the patients underwent surgical treatments via a transcaruncular approach, for which the Medpor was used. Postoperative complications include 6 cases of the limitation of extraoccular movement, 10 cases of diplopia, and 7 cases of enophthalmos. However, there were no specific complications caused by Tisseel. All the patients were satisfied with the treatment outcomes. In this study, we report the usefulness of Tisseel in the fixation of the medial orbital wall fracture using the Medpor implant with a review of literatures.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations鈥揷itations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright 漏 2024 scite LLC. All rights reserved.
Made with 馃挋 for researchers
Part of the Research Solutions Family.