Autologous fat transfer rescues expanded skin from expansion failure: A retrospective cohort study in Asians

xlomafota13 shared this article with you from Inoreader Autologous fat transfer rescues expanded skin from expansion failure: A retrospective cohort study in Asians Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 18:S1748-6815(21)00599-4. doi: 10.1016/j.bjps.2021.11.055. Online ahead of print. ABSTRACT BACKGROUND: Soft tissue expansion is a common technique for the regeneration of extra skin to repair skin defects. However, some warning signs like skin thinning and telangiectasia are often found during the expansion process, which indicates the skin flaps cannot be further expanded. These signs may result in the suspension of expansion or ultimately jeopardize the final outcome. Fat grafting is used to treat these potential complications and enable the continuation of the expansion procedure in some cases. In this study, we aimed to investigate the efficiency and safety of fat grafting in this process. METHODS: The study was conducted on patients from January 2012 to December 2017 with warning signs of expansion treated with fat grafting (treatment group) or pause expansion (control group). Follow-u p data, such as expansion status, dermal thickness, telangiectasia, skin texture using volume assessment, B-mode ultrasound, and semiquantitative scoring, were collected. RESULTS: A total of 67 expanded skin regions with warning signs were enrolled. The expansion fold increased 2.14-fold at 12 weeks after treatment compared with 0.74-fold in control (P=0.02). The semiquantitative score was significant improved at 4 weeks (9.03 ± 0.73 vs. 7.45 ± 0.55; p=0.033). Meanwhile, the skin thickness in the experimental group did not show decreasing trend even in the continued expansion process. CONCLUSIONS: Autologous fat grafting represents an effective and safe method to rescue expanded skin from limited skin regeneration. This technique also represents a valuable tool to increase the chances for further expansion. PMID:34903491 | DOI:10.1016/j.bjps.2021.11.055 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

E‐cigarette use and tobacco harm reduction: A pilot survey study evaluating perspectives of head and neck surgeons

xlomafota13 shared this article with you from Inoreader E‐cigarette use and tobacco harm reduction: A pilot survey study evaluating perspectives of head and neck surgeons Via Head & Neck Abstract Background Electronic cigarettes (EC) are popular devices that aerosolize a nicotine and have been controversially considered tool for smoking cessation and tobacco harm reduction (THR). The purpose of this pilot study was to identify head and neck cancer (HNC) surgeons' attitudes/perspectives of EC and smoking cessation counseling. Methods Cross-sectional survey administered to American Head and Neck Society (AHNS) members. Results Response rate was 136 members (15.1%) with the majority 102 (75.00%) having unfavorable attitude toward EC for smoking cessation. Fifty-eight respondents (42.7%) were familiar with THR. Those familiar with THR 37 (63.79%) routinely inquire about EC use. Compared between THR familiarity, 22 (37.93%) believed the benefits of EC for smoking cessation outweighed the potential risks. Conclusions HNC specialists have an unfavorable attitude toward EC. Those familiar with THR were more likely to inquire about EC use. They were also less likely to have a definitive opinion on the benefits of quitting combustible cigarettes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hearing Loss and Its Burden of Disease in a Large German Cohort—Hearing Loss in Germany

xlomafota13 shared this article with you from Inoreader Hearing Loss and Its Burden of Disease in a Large German Cohort—Hearing Loss in Germany Via The Laryngoscope Objectives/Hypothesis Hearing loss is the most common sensory impairment worldwide. It restricts patients in many aspects of their daily lives and can lead to social exclusion. Understanding this burden is a mandatory requirement for the care of those affected. Therefore, the aim of this study was to estimate the burden of hearing loss in a large German cohort. Study Design Cohort study. Methods The Gutenberg Health Study is designed as a single-center, prospective, and observational cohort study and representative for the city of Mainz, Germany, with its district. Participants were interviewed concerning common otologic symptoms and tested by pure-tone audiometry. The primary outcome was hearing impairment stratified by age and sex. The prevalence of tinnitus was estimated for a subcohort to calculate disability-adjusted life years (DALYs). All results were weighted by the European Standard Population (ESP) 2013. Results A total of 5,024 participants (mean age: 61.2 years, 2,591 men and 2,433 women) were included in the study. Hearing impairment showed the following prevalence: 28.2% (95% confidence interval [CI], 26.9%–29.4%) mild impairment, 10.1% (95% CI, 9.3%–11.0%) moderate impairment, 2.3% (95% CI, 1.9%–2.7%) moderately severe impairment, 0.2% (95% CI, 0.1%–0.4%) severe impairment, 0% (95% CI, 0.0%–0.1%) profound impairment, and 0.1% (95% CI, 0.0%–0.2%) complete impairment. Weighted for the ESP 2013 (all ages), hearing impairment across all levels (with/without tinnitus) causes a total of 2,118.97 DALYs per 100,000. Conclusion With 40.9% affected, the hearing loss represents a relevant burden of the German population. Understanding this will provide the basis for future guidelines on how to care for these patients. Level of Evidence 2 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Skin Color Match in Head and Neck Reconstructive Surgery

xlomafota13 shared this article with you from Inoreader Skin Color Match in Head and Neck Reconstructive Surgery Via The Laryngoscope Objectives/Hypothesis To quantify the degree of color match achieved during microvascular facial reconstruction, and to describe a novel technique for improving reconstructive skin color match. We hypothesize that split-thickness skin grafts (STSG) placed atop de-epithelialized free tissue produces better facial skin color match than free tissue with intact epithelium. Study Design Cross sectional photographic study of reconstructed facial skin color match. Methods Sixty-eight adults, who underwent head and neck reconstructive surgery, were divided into six categories based on cutaneous reconstructive technique: cervicofacial flap, radial forearm free flap (RFFF), fibula free flap, anterolateral thigh free flap (ALT), STSG over adiopofascial flap (STAFF), and STSG over myogenous flap (STMF). Averaged color samplings of the reconstructed defect and adjacent normal skin were taken from digital photographs. The color difference was calculated using the delta-E calculation. Blinded expert observers also rated the degree of color match. Nonparametric cohort contrast and correlation statistical analyses were performed. Results The mean delta-E's and 10-point Likert ratings for the ALT, fibula, RFFF, STAFF, STMF, and cervicofacial flaps were 11.6, 10.0, 7.7, 6.3, 8.8, and 4.7, and 5.1, 6.4, 2.4, 3.2, 2.7, and 1.1, respectively. Likert scale inter-rater correlation was strong, with coefficient = 0.80. Conclusions On average, STSG over de-epithelialized myogenous and adipofascial free tissue transfers produced a better color match than the skin paddles of donor sites, with the exception of the radial forearm donor site. Delta-E values obtained from photos correlated well with expert ratings of color match. This reliable technique for quantifying color match may be used in future studies. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Case Report of a Middle Ear Mass Originated From Cartilage-like Tissue Treated With Transcanal Endoscopic Ear Surgery

xlomafota13 shared this article with you from Inoreader A Case Report of a Middle Ear Mass Originated From Cartilage-like Tissue Treated With Transcanal Endoscopic Ear Surgery Via ear nose throat Ear Nose Throat J. 2021 Dec 14:1455613211065510. doi: 10.1177/01455613211065510. Online ahead of print. ABSTRACT Middle ear tumors are relatively rare, and among them, the diagnoses of middle ear lesions originating from cartilage-like tissue are even rarer. Use of transcanal endoscopic ear surgery (TEES) has increased in recent years because of its advantages, such as clear visual field and minimally invasive procedure. Here, we report a middle ear mass originating from car tilage-like tissue treated with TEES. A 62-year-old woman presented with progressive right-sided hearing loss. A white mass was revealed through the tympanic membrane, and pure-tone audiometry detected a mean 50.0 dB conductive hearing loss. Computed tomography showed a mass in the tympanic cavity. TEES was performed for diagnosis and treatment. A white translucent tumor was observed intraoperatively, and it was completely resected. Histopathological examination confirmed the diagnosis of a mass originating from degenerated cartilage-like tissue. To the best of our knowledge, this is the first study of a middle ear mass originating from cartilage-like tissue treated with TEES. TEES with its clear visual field and precise techniques was beneficial in treating the middle ear lesions circumscribed in the tympanic cavity. PMID:34904447 | DOI:10.1177/01455613211065510 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Root Cause Analysis of Na131I Contamination

xlomafota13 shared this article with you from Inoreader Root Cause Analysis of Na<sup>131</sup>I Contamination Via radioactive iodine J Nucl Med Technol. 2021 Dec;49(4):350-353. doi: 10.2967/jnmt.121.262492. ABSTRACT Establishing a cause-and-effect relationship for an adverse event is one of the key steps in preventing them and involves multiple people, resources, and steps, thus requiring a root cause analysis. Here, we describe a root cause analysis performed in the nuclear medicine department for an event involving Na131I contamination. Oral administration of Na131I in a capsule minimizes the risk of contamination and spills. However, the patient must be able to swallow a capsule. Na131I in capsule form is currently in widespread use for treatment of hyperthyroidism and thyroid cancer. Na131I in liquid form is rarely available immediately on demand and must be ordered at least 24-48 h in advance of the planned administration. The events leading to the incident, immediate remedial steps taken, and subsequent root cause analysis are described. The corrective actions taken after the root cause analysis, as well as the subsequent effectiveness of these actions, are mentioned. There may be one or multiple causes for an adverse event. It is important to identify the root cause. Corrective actions derived from the root cause can help prevent similar adverse events in the future. Therapeutic procedures in nuclear medicine involve unsealed radioactive sources, further adding a separate layer of immediate steps and reporting to the root cause analysis it self. PMID:34862264 | DOI:10.2967/jnmt.121.262492 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic Anatomy of the Zygomatic Nerve: Implications for the Endoscopic Transmaxillary Approach

xlomafota13 shared this article with you from Inoreader Endoscopic Anatomy of the Zygomatic Nerve: Implications for the Endoscopic Transmaxillary Approach Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1739237 Background Understanding the anatomic features of the zygomatic nerve is critical for performing the endoscopic transmaxillary approach properly. Injury to the zygomatic nerve can result in facial numbness and corneal problems. Objective To evaluate the surgical anatomy of the zygomatic nerve and its segments from an endoscopic endonasal perspective for clinical implications of performing the endoscopic transmaxillary approach. Methods The origin, course, length, and segments of the zygomatic nerve were studied in four specimens from an endonasal perspective. Results The zygomatic nerve arises 4.1 ± 1.7 mm from the foramen rotundum of the maxillary nerve in the superolateral pterygopalatine fossa (PPF). According to its anatomic region in endonasal endoscopic surgery, we divided the zygomatic nerve into two segments: the PPF segment, from origin to the point of entry under Muller's muscle, which runs superolaterally to the inferior orbital fissure (IOF) (length, 4.6 ± 1.3 mm), and the IOF segment, starting at the entry point in Muller's muscle and terminating at the exit point in the IOF, which travels between Muller's muscle and the great wing of the sphenoid bone (length, 19.6 ± 3.6 mm). In the transmaxillary approach, the zygomatic nerve is a critical landmark in the superolateral PPF. Conclusion The zygomatic nerve travels in the PPF and the IOF; better visualization and preservation of this nerve during endonasal endoscopic surgery are crucial for successful outcomes. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.