The Melbourne method of total vault remodeling was developed at The Royal Children's Hospital (Melbourne) to address all phenotypic aspects of scaphocephaly. To quantitatively evaluate this technique, a retrospective analysis was performed on 33 consecutive patients who underwent the Melbourne procedure between October 2004 and June 2007. To monitor outcomes, three-dimensional digital surface photography was used, obtaining 4 anthropometric measurements (cranial length, cranial width, head circumference, auricular head height) preoperatively and postoperatively. To assess the effect on continuing cranial vault development, cranial volume was calculated with computed tomography. Anthropometric measurements were obtained in 27 patients (81.8%), with a mean postoperative follow-up of 8.9 months. Cranial index (width/length) demonstrated an 11.1% improvement. The mean head circumference in the scaphocephaly group preoperatively remained larger than the normative population postoperatively, although the magnitude of difference was decreased, whereas the mean auricular head height demonstrated a 10.5% increase postoperatively, remaining higher than the normative population. Cranial volume was calculated in 30 patients (91%), with a mean postoperative follow-up of 7.9 months. This demonstrated that the mean intracranial volume was significantly higher in the scaphocephaly group preoperatively, and this difference was maintained postoperatively. These results support our belief that the Melbourne procedure is a technique that may be used to correct all phenotypic aspects of scaphocephaly, with no apparent evidence for a detrimental effect on cranial growth.
Lipoblastoma is a rare benign neoplasm of infancy and childhood with the potential for locally invasive, rapid growth. It has an excellent prognosis, and does not metastasise. An important differential diagnosis for these rapidly-enlarging tumours is liposarcoma. Ultrasound, magnetic resonance imaging, fine needle aspiration, and cytogenetics are important diagnostic tools for this rare tumour. We present two cases of lipoblastoma of the hand that were excised within a three month period with no evidence of recurrence at 14, and 12, months respectively.
BackgroundIn 2021, breast cancer was one of the most commonly diagnosed cancer in Australia. While a mastectomy remains a treatment of choice, only a small percentage of women have access to a breast reconstruction after. Women living in a rural area are less likely to have a breast reconstruction; compared to their metropolitan counterparts. This study analyses the impact of single breast reconstruction service on a Modified Monash 3 (MM3) region and informs consumers and providers of the importance of a breast reconstruction unit embedded in a rural health network. [Corrections added on 2 May 2023, after online publication. Expanded reference citations have been deleted from Abstract section.]MethodsFollowing ethics approval, all 64 patients who had undergone a breast reconstruction with this service between 2017 and 2021 were contacted. Patient reported outcomes were recorded through phone interviews, using a standardized questionnaire. For each patient that presented to the rural centre, cost of travel and productivity loss were also calculated, and compared to the closest metropolitan centre.ResultNinety‐seven percent of the 38 participants strongly valued having a breast reconstruction service within their community. Eighty percent of participants were satisfied with their result. Patients were estimated to save on average $8478, by attending the rural breast reconstruction service.ConclusionAccess to a breast reconstruction is significantly impacted by geographical barriers. A rural breast reconstruction service can improve patient access and satisfaction, while also reducing the financial burden on patients.
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