Patient reported outcome measures in a cohort of patients at high risk of breast cancer treated by bilateral risk reducing mastectomy and breast reconstruction

xlomafota13 shared this article with you from Inoreader Patient reported outcome measures in a cohort of patients at high risk of breast cancer treated by bilateral risk reducing mastectomy and breast reconstruction Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 21:S1748-6815(21)00345-4. doi: 10.1016/j.bjps.2021.06.012. Online ahead of print. ABSTRACT BACKGROUND: Many women with increased lifetime risk of developing breast cancer, due to pathogenic gene variants or family history, choose to undergo bilateral risk reducing mastectomies (BRRM). Patient reported outcome measures (PROMS) are an increasingly important part of informed consent but are little studied in women undergoing BRRM. METHODS: We used a validated PROMS tool for breast reconstruction (BREAST-Q) in 297 women who had BRRM and breast reconstruction, 81% of whom had no malignancy (Benign Group, BG) and 19% in whom a perioperative breast cancer was diagnosed (Cancer Group, CG). 128 women also completed a Hospital Anxiety & Depression Score (HADS) questionnaire to test if preoperative HADS score could predict PROMS outcomes. RESULTS: Women in the CG had lower PROMS scores for s atisfaction with their breasts, nipple reconstruction and sexual wellbeing. Both groups reported equal satisfaction with BRRM outcome and psychosocial well-being. Physical well-being PROMS of the abdomen and chest were high in women in both groups as were scores for satisfaction with the care they received. The CG group reported suboptimal quality of patient information. A higher presurgical HADS anxiety score predicted less favourable postoperative psychosocial well-being despite similar levels of satisfaction with aesthetic outcome. CONCLUSION: We show a high degree of patient reported satisfaction by woman undergoing BRRM and reconstruction. There was a negative association with a cancer diagnosis on quality of life PROMS and higher preoperative anxiety levels negatively affected postoperative psychosocial well-being. These important findings should be part of the informed consent process during preoperative counselling. PMID:34219040 | DOI:10.1016/j.bjps.2021.06.012 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical management of female genital mutilation-related morbidity: A scoping review

xlomafota13 shared this article with you from Inoreader Surgical management of female genital mutilation-related morbidity: A scoping review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 6:S1748-6815(21)00274-6. doi: 10.1016/j.bjps.2021.05.022. Online ahead of print. ABSTRACT BACKGROUND: Over 200 million women and girls worldwide have suffered from the partial to total removal of external female genitalia for nonmedical purposes, referred to as female genital mutilation (FGM). Survivors of FGM may develop debilitating physical and psychological long-term sequelae. This is the first study to examine the scope of the extant surgical literature on the management of FGM-related morbidity. METHODS: A systematic scoping review of five major research citation databases was conducted. RESULTS: A total of 190 articles from 29 countries met the inclusion criteria. The majority (76%) were primary source articles and from obstetrics and gynecology literature (71%). Reported interventions for FGM-related morbidity were defibulation, cyst excision, clitoral and vulvar reconstructio n, urological reconstruction, peripartum procedures, labial adhesion release, and reinfibulation. CONCLUSIONS: Surgery for FGM complications spans multiple specialties, which suggests multidisciplinary collaboration benefit. Plastic and reconstructive surgeons have a clear role in the multidisciplinary care team for these patients. This scoping review identified a paucity of high-quality evidence with respect to functional quality of life outcomes and long-term follow-up. PMID:34219039 | DOI:10.1016/j.bjps.2021.05.022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary Laryngeal Granulocytic Sarcoma: A Case Report

xlomafota13 shared this article with you from Inoreader Primary Laryngeal Granulocytic Sarcoma: A Case Report Via Otolaryngology Indian Abstract Granulocytic sarcoma (GS) is a malignancy of the bone marrow precursor cells, often associated with acute or chronic myeloid leukemia, forming isolated masses with extramedullary spread. It rarely shows laryngeal involvement. In this case report, a case of GS accompanying acute myeloid leukemia involving larynx with mass of neck and mediastinum as two separate masses was presented. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pericranial and scalp rotation flaps for occipitocervical hardware exposure with CSF leak in rheumatoid arthritis patient: A case report and review of the literature

xlomafota13 shared this article with you from Inoreader Pericranial and scalp rotation flaps for occipitocervical hardware exposure with CSF leak in rheumatoid arthritis patient: A case report and review of the literature Via leak of cerebrospinal fluid Surg Neurol Int. 2021 May 17;12:229. doi: 10.25259/SNI_351_2021. eCollection 2021. ABSTRACT BACKGROUND: There are several etiologies of craniocervical junction instability (CCJI); trauma, rheumatoid arthritis (RA), infections, tumors, congenital deformity, and degenerative processes. These conditions often require surgery and craniocervical fixation. In rare cases, breakdown of such CCJI fusions (i.e., due to cerebrospinal fluid [CSF] leaks, infection, and wound necrosis) may warrant the utilization of occipital periosteal rescue flaps and scalp rotation flaps to achieve adequate closure. CASE DESCRIPTION: A 33-year-old female with RA, cranial settling, and high cervical cord compression underwent an occipitocervical instrumented C0-C3/C4 fusion. Two months later, revision surgery was required due to articular screws pull out, CSF leakage, and infection. At the second surgery, the patient required screws removal, the application of lami nar clamps, and sealing the leak with fibrin glue. However, the CSF leak persisted, and the skin edges necrosed leaving the hardware exposed. The third surgery was performed in conjunction with a plastic surgeon. It included operative debridement and covering the instrumentation with a pericranial flap. The resulting cutaneous defect was then additionally reconstructed with a scalp rotation flap. Postoperatively, the patient adequately recovered without sequelae. CONCLUSION: A 33-year-old female undergoing an occipitocervical fusion developed a postoperative persistent CSF leak, infection, and wound necrosis. This complication warranted the assistance of plastic surgery to attain closure. This required an occipital periosteal rescue flap with an added scalp rotation flap. PMID:34221560 | PMC:PMC8248012 | DOI:10.25259/SNI_351_2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Delayed subaponeurotic fluid collection on an infant's head: Underreported case and review of the literature

xlomafota13 shared this article with you from Inoreader Delayed subaponeurotic fluid collection on an infant's head: Underreported case and review of the literature Via leak of cerebrospinal fluid Surg Neurol Int. 2021 May 17;12:233. doi: 10.25259/SNI_932_2020. eCollection 2021. ABSTRACT BACKGROUND: Delayed subaponeurotic fluid collection (DSFC) is a relatively uncommon problem, probably under reported soft swelling in the scalp which usually develops in infancy that occurs weeks to months after birth. Although the exact etiology remains unclear, several theories have been postulated such as (i) cerebrospinal fluids (CSF) leak from microfractures of the skull and (ii) disrupted lymphatic drainage, gradually liquefying subaponeurotic bleeding. Here, we reported typical clinical findings of DSFC and analysis of the fluid aspirate from our patient. To the best of our knowledge, this is the first case reported from Asia, particularly from Indonesia. CASE DESCRIPTION: A healthy 2-month-old girl infant presented with 2 weeks history of occipital painless fluctuant scalp mass with no swelling. She was born at term from a nulliparous mot her; by emergency cesarean delivery following failed induction of labor. There was no history of scalp injury at birth nor recent head trauma; ultrasonography showed translucent fluid in subaponeurotic or subgaleal space. The fluid collection was noted to be fluctuant, free-flowing across suture lines, without discoloration or bruising; when placed supine, the fluid collected at her midocciput. A diagnostic tap confirmed the presence of serosanguinous CSF led to a diagnosis of DSFC. CONCLUSION: Herein, we reported the first DSFC case from Indonesia. With no previous experience of the condition, a definitive diagnosis was possible through a very carefully physical examination and history taking, along with a good communication among the neurosurgeon, pediatrician, and the clinical pathologist. PMID:34221564 | PMC:PMC8247724 | DOI:10.25259/SNI_932_2020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Factors associated with cerebrospinal fluid leak after a retrosigmoid approach for cerebellopontine angle surgery

xlomafota13 shared this article with you from Inoreader Factors associated with cerebrospinal fluid leak after a retrosigmoid approach for cerebellopontine angle surgery Via leak of cerebrospinal fluid Surg Neurol Int. 2021 Jun 7;12:258. doi: 10.25259/SNI_42_2021. eCollection 2021. ABSTRACT BACKGROUND: The retrosigmoid approach represents a crucial surgical route to address different lesions in the cerebellopontine angle but cerebrospinal fluid (CSF) leak still remains the most frequent complication after this approach. Here, we analyzed the impact of different factors in CSF leak development after a retrosigmoid approach. Identifying risk factors related to a specific approach may help the surgeon to tailor the perioperative management and to appropriately counsel patients regarding their risk profile. METHODS: We retrospectively reviewed the clinical, surgical, and outcome data of 103 consecutive patients (M/F, 47/56; mean follow-up 35.6 ± 23.9 months) who underwent a retrosigmoid approach for different cerebellopontine angle pathologies and studied the impact of different factors on the occurrence of a CSF leak to univariate and m ultivariate analysis. RESULTS: Seventy-nine patients (76.7%) were operated for tumors growing in the cerebellopontine angle. Twenty-four patients (23.2%) underwent microvascular decompression to treat a drug-resistant trigeminal neuralgia. Sixteen patients (15.5%) developed CSF leak in the postoperative course of which six underwent surgical revision. Performing a craniectomy as surgical procedure (P = 0.0450) and performing a reopening procedure (second surgery; P = 0.0079) were significantly associated to a higher risk of developing CSF leak. Moreover, performing a reopening procedure emerged as an independent factor for CSF developing on multivariate analysis (P = 0.0156). CONCLUSION: Patients submitted to craniectomy and patients who underwent a second surgery showed an higher CSF leak rate. Ongoing improvement of biomaterial technology may help neurosurgeons to prevent this potentially life-threatening complication. PMID:34221589 | PMC:PMC8247722 | DOI:10.25259/SNI_42_2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Apocrine Hidrocystoma of the Parotid Gland

xlomafota13 shared this article with you from Inoreader Apocrine Hidrocystoma of the Parotid Gland Via ear nose throat Ear Nose Throat J. 2021 Jul 5:1455613211031028. doi: 10.1177/01455613211031028. Online ahead of print. ABSTRACT Apocrine hidrocystoma is a cystic tumor originating from apocrine sweat glands. It is predominantly located in the eyelid margins. Here, we report a case of apocrine hidrocystoma of the parotid gland in a 19-year-old man who was referred to our outpatient clinic with a 5-year history of a gradual swelling in the left parotid region. The patient underwent left super ficial parotidectomy. Histological examination confirmed the diagnosis of apocrine hidrocystoma. The case is original by the tumor's location: to the best of our knowledge, this could be the first case in English and French literature reporting an apocrine hidrocystoma affecting the parotid gland. The purpose of this article is to report our case and discuss its clinical and anatomopathological features as well as its differential diagnoses. PMID:34219505 | DOI:10.1177/01455613211031028 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Cause of Red Tympanic Membrane: Jugular Bulb Diverticulum

xlomafota13 shared this article with you from Inoreader A Rare Cause of Red Tympanic Membrane: Jugular Bulb Diverticulum Via ear nose throat Ear Nose Throat J. 2021 Jul 5:1455613211031384. doi: 10.1177/01455613211031384. Online ahead of print. ABSTRACT SIGNIFICANCE STATEMENT: Pulsatile tinnitus with erythematous tympanic membrane mass suggests vascular pathologies such as dural arteriovenous fistula, glomus tympanicum, or aberrant carotid artery. Jugular bulb aneurysmatic diverticulum is rare but should be suspected in a case with the presence of aneurysm in other organs. An imaging study is mandatory to confirm the diagnosis. Patient must avoid digging ear as it can cause profuse bleeding. Treatment option can be open surgery or endovascular treatment. PMID:34219487 | DOI:10.1177/01455613211031384 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Unusual Case of a Pharyngeal Fistula to the Cervical Spine Causing Osteomyelitis

xlomafota13 shared this article with you from Inoreader An Unusual Case of a Pharyngeal Fistula to the Cervical Spine Causing Osteomyelitis Via ear nose throat Ear Nose Throat J. 2021 Jul 5:1455613211029773. doi: 10.1177/01455613211029773. Online ahead of print. ABSTRACT SIGNIFICANCE STATEMENT: Pharyngeal fistulas to the cervical spine resulting in vertebral osteomyelitis are a rare, yet clinically important, complication of total laryngectomy performed in conjunction with chemoradiotherapy or radiation therapy. This complication is likely underdiagnosed and can have a high mortality rate. It is very important that clinicians are a ware of this complication as early diagnosis and management may improve patient outcomes. PMID:34219496 | DOI:10.1177/01455613211029773 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Simultaneous Sudden Hearing Loss and Peripheral Facial Paralysis in a Patient With Covid-19

xlomafota13 shared this article with you from Inoreader Simultaneous Sudden Hearing Loss and Peripheral Facial Paralysis in a Patient With Covid-19 Via ear nose throat Ear Nose Throat J. 2021 Jul 5:1455613211028094. doi: 10.1177/01455613211028094. Online ahead of print. ABSTRACT Although peripheral facial paralysis and sudden sensorineural hearing loss are not as common as anosmia, they are reported neurological manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We present a 62-year-old, serologically COVID-19 positive woman with seventh and eighth nerve involvement showed electrophysiologically with Auditory B rainstem Response and electroneurography and radiologically with internal acoustic canal magnetic resonance imaging. This single case report suggests a possible association between the SARS-CoV-2 infection with simultaneous sudden sensorineural hearing loss and isolated facial paralysis. However, further studies are needed to determine whether this relationship is coincidental or occasional. PMID:34219500 | DOI:10.1177/01455613211028094 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Atypical Carcinoid of the Larynx: A Case Report

xlomafota13 shared this article with you from Inoreader Atypical Carcinoid of the Larynx: A Case Report Via ear nose throat Ear Nose Throat J. 2021 Jul 5:1455613211024868. doi: 10.1177/01455613211024868. Online ahead of print. ABSTRACT Neuroendocrine carcinomas are a spectrum of rare and highly heterogeneous malignant tumors. Neuroendocrine carcinomas mainly arise from neuroendocrine cells scattered throughout the body. They mainly occur in the lung and gastrointestinal tract. Atypical carcinoid of the larynx is a rare type of neuroendocrine carcinoma, which is easily misdiagnosed as hemangioma i n appearance. We mainly feature the disease to you through the diagnosis and treatment of a case of atypical carcinoid of the larynx. PMID:34219499 | DOI:10.1177/01455613211024868 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.