In this study, we found that more than three quarters (81%) of the patients who were treated for velopharyngeal insufficiency with Orticochea pharyngoplasty presented obstructive sleep apnea when analyzing the apnea/hypopnea index in the polysomnography sleep study.

Background:Gouty panniculitis is a rare clinical manifestation of gout, characterized by deposits of monosodium urate crystals in the hypodermis. Our aim was to describe atypical and rare clinical presentations of gouty tophi.Methods:We searched relevant English and Spanish literature of unusual gout manifestations using the following keywords: giant, gout, panniculitis, gouty panniculitis, gouty tophi, rare manifestations of gout, gouty, tophi, tophus, monosodium urate, uric acid, and unusual. Well-described case reports, case series, and review articles were evaluated and included in the literature review.Results:International literature has reported fewer than 10 cases of gouty panniculitis worldwide. In this case report, the patient presents a rare manifestation of gouty panniculitis, with typical joint injuries, gouty tophi in both lower and upper extremities, chronic gouty tophi in the nose, for which only 3 cases have been reported in literature, and great hypertrophy of adipose tissue in the lower back.Conclusions:Tophi can be found in atypical locations, which increase morbidities and deformities caused by the disease. We report an interesting case of gouty panniculitis associated with great hypertrophy of the adipose tissue, a rare manifestation of gout, and unusual locations of tophi. These clinical manifestations in our patient have not been recorded before, which leads us to think that we are in the presence of a new dermatological manifestation of gout.

Background: Burn patients experience major physiological and psychological stressors during treatment and rehabilitation, including elevated levels of pain, anxiety, stress, or depression. Music interventions inclusive of music therapy (MT) have been shown to improve such symptoms, but rigorous clinical trials investigating specific music therapy methods in adult burn patients are scarce.Methods: This is a single center Randomized Controlled Trial (RCT) protocol with two parallel arms. Participants are 81 adult burn patients admitted to the Intensive Care Unit (ICU) of the University Hospital Fundación Santa Fe de Bogotá in Colombia. The intervention consists of a Music Assisted Relaxation (MAR) protocol, a music therapy technique composed of entrained live music combined with a guided relaxation and/or the use of imagery. The effects of the MAR will be compared to a control group (treatment as usual) over a period of maximum 2 weeks or six interventions. The primary outcome measure is perceived background pain, as measured with a Visual Analog Scale (VAS) before and after each intervention. Secondary outcomes are anxiety and depression levels; vital signs; and the use of pain medication. Additionally, some patients in the intervention group will be invited to participate in electroencephalography, electromyography, and electrocardiography recordings during the MAR.Discussion: This study protocol follows the SPIRIT guidelines for defining items of clinical trials and is the first study in Colombia to evaluate the effects of music therapy for adult burn patients. With this RCT it is hoped to gather new knowledge about the potential of music therapy to help critical care patients cope and recover from their injuries during the hospitalization in the ICU.Trial registration:www.clinicaltrials.gov, Identifier: NCT04571255.Protocol version: V1.0, May 24th 2021

Less invasive treatment options exist for hemifacial atrophy from Parry-Romberg syndrome.

Aim: The aim of the study was to describe the applicability of a single-layer acellular dermal matrix, in combination with split-thickness skin graft (STSG) in one-stage surgical procedure in patients with deep neck second-and third-degree burns.

This article presents the case of a newly born female patient with a cleft of the primary palate (alveolar cleft), with an in utero diagnosis of the described cleft, from whom umbilical cord stem cells are obtained and cryopreserved. The patient is managed with nasoalveolar molding, and at 5 months of age, she is taken to surgery for cheiloplasty and gingivoperiostioplasty with umbilical cord stem cells. A radiographic and CT follow-up is carried out on the described cleft.

Craniomaxillofacial trauma has been reported to occur in 20 to 30% of all trauma patients.1,2 Maxillofacial injuries traditionally have been treated as a separate entity, but clinical research has tried to establish a correlation between them and concomitant skull base injuries. The closeness of these bones to the cranium would suggest that there are chances of cranial injuries also occurring simultaneously, and except for a few studies, there is a general dearth of data trying to establish a correlation between them. A classification based on the mechanism of the trauma was described by Manson et al. In this classification the mechanism of the trauma was divided into low-, middle-, and AbstractBackground and Purpose Sphenoid bone fractures and sphenoid sinus fractures have a high morbidity due to its association with high-energy trauma. The purpose of this study is to describe individuals with traumatic injuries from different mechanisms and attempt to determine if there is any relationship between various isolated or combined fractures of facial skeleton and sphenoid bone and sphenoid sinus fractures. Methods We retrospectively studied hospital charts of all patients who reported to the trauma center at Hospital de San José with facial fractures from December 2009 to August 2011. All patients were evaluated by computed tomography scan and classified into low-, medium-, and high-energy trauma fractures, according to the classification described by Manson. Design This is a retrospective descriptive study. Results The study data were collected as part of retrospective analysis. A total of 250 patients reported to the trauma center of the study hospital with facial trauma. Thirtyeight patients were excluded. A total of 212 patients had facial fractures; 33 had a combination of sphenoid sinus and sphenoid bone fractures, and facial fractures were identified within this group (15.5%). Gender predilection was seen to favor males (77.3%) more than females (22.7%). The mean age of the patients was 37 years. Orbital fractures (78.8%) and maxillary fractures (57.5%) were found more commonly associated with sphenoid sinus and sphenoid bone fractures. Conclusions High-energy trauma is more frequently associated with sphenoid fractures when compared with medium-and low-energy trauma. There is a correlation between facial fractures and sphenoid sinus and sphenoid bone fractures. A more exhaustive multicentric case-control study with a larger sample and additional parameters will be essential to reach definite conclusions regarding the spectrum of fractures of the sphenoid bone associated with facial fractures.

Summary: Electrical burns are capable of damaging cells through both thermal and nonthermal mechanisms. The complexity of these wounds, the deterioration in time, and the conversion during the first days make managing them a challenge. Negative pressure wound therapy (NPWT) is a technology that can be used as a tool to improve outcomes in patients with burns in the acute and reconstructive phases of the treatment. We describe 2 cases in which we apply this technology in electrical injuries. We present 2 cases of patients with electrical burns who underwent NPWT with instillation (NPWTi) with saline solution in the acute phase, to block the conversion of the burn and to improve the granulation tissue and in the reconstructive phase, as a tool to improve the grafts take. Both patients showed early formation of granulation tissue adequate for surgical reconstruction, and neither of them presented loss of skin grafts. In the acute phase, NPWT with instillation when applied in these patients showed fast formation of granulation tissue adequate for early reconstruction, whereas NPWT in the reconstructive phase when applied to bolster grafts showed improvements in grafts take. NPWT is a useful tool to support the surgical management of the electrical injuries during the acute phase to prepare the wound for early reconstruction and after the skin grafts reconstruction to improve the grafts take.