Hemimegalencephaly

Massimi, Luca; Rocco, Concezio Di

doi:10.1007/978-3-319-72168-2_47

Cited by 2 publications

(5 citation statements)

References 159 publications

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“…Skeletonization was needed in 24.32% of the cases, and further perforator dissection within the muscle was needed in 10.81% of the cases. These results differ from other studies that recommend leaving a cuff of soft tissue around the perforator to avoid vessel spasms 5,8,13 …”

Section: Discussioncontrasting

confidence: 99%

“…However, our postoperative results are not consistent with other reports showing no complications 1 . The evidence of complications in our study for partial distal flap ischemia and wound dehiscence was similar to previous studies 7–9 . Postoperative partial ischemia and dehiscence occurred in 8.7% of cases, and CSF leakage was detected in 13% of cases.…”

Section: Discussioncontrasting

confidence: 61%

“…Myelomeningocele is considered surgical emergency condition intervention by dural repair, and soft tissue defect reconstruction should be done as early as possible provided that the newborn general condition is good and there are no signs of meningeal infection. According to studies, recommendation surgery is usually performed within the first 48 hours of life 8,9 …”

Section: Discussionmentioning

confidence: 99%

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A New Dissection Ladder Approach for Perforator Vessels in Infant Meningomyelocele Soft Tissue Reconstruction

et al. 2022

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Background: Meningomyelocele reconstruction is a lifesaving procedure. A freestyle propeller perforator flap is an ideal option for moderate to large soft tissue meningomyelocele reconstruction. Previous studies that focused on the reliability of perforator flaps for meningomyelocele reconstruction recommended preserving a cuff of soft tissue around the perforators to avoid vasospasm. This method is a very conservative approach in comparison to the recently well-established principles of pedicled perforator flap dissection. In this study, we used a dissection ladder approach. In this method, the pedicle is freed by just islanding the pedicle, skeletonization of the perforator, or further dissection of the perforators beyond the muscles, based on intraoperatively monitoring of the flap. Materials and Methods: Thirty-six infants with a mean age of 2.1 ± 1.1 months underwent surgery for dorsolumbar meningomyelocele at Assuit University Hospital for 3 years. During surgery, the freestyle perforator flap followed a dissection ladder for perforating vessels and intraoperative flap monitoring. Flap viability, seroma, hematoma, and cerebrospinal fluid leakage were evaluated. Results: Nine cases required perforator skeletonization, 4 cases required dissection beyond the muscle, and 23 cases required islanding the flap on the perforators. The average operative time was 43.37 ± 7.87 minutes. Partial tip ischemia was detected in 2 cases. These cases exhibited partial dehiscence and healed by secondary intention. Complete flap loss did not occur in any cases. Conclusions: A conservative approach for perforator flap elevation in infants did not provide optimal results in all cases of thoracolumbar meningomyelocele reconstructions. Well-established principles of perforator dissection, including skeletonization and dissection beyond the muscle, are safe, prevent vasospasms, and improve flap viability.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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A New Dissection Ladder Approach for Perforator Vessels in Infant Meningomyelocele Soft Tissue Reconstruction

et al. 2022

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“… 4 The term “brachycephaly” is derived from the Greek words “brakhu” (short) and “cephalos” (head), which translates to “short head,” referring to the premature obliteration of the bilateral coronal CSs. 5 Bilateral flattening of the occiput in infants with this condition results in a smaller anteroposterior cranial dimension and a larger mediolateral dimension. 6 This condition also leads to a vertically tall (towered‐shaped) skull.…”

Section: Introductionmentioning

confidence: 99%

“… 7 These cases necessitate a more complex treatment; for cases with a late diagnosis, more than one surgery is required to restore the normal shape of the head. 5 …”

Section: Introductionmentioning

confidence: 99%