45 research outputs found

    Resorbable Mesh Cranioplasty Repair of Bilateral Cerebrospinal Fluid Leaks Following Pediatric Simultaneous Bilateral Auditory Brainstem Implant Surgery

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    OBJECTIVE: To present a child with cochlear nerve deficiency (CND) who received simultaneous bilateral simultaneous auditory brainstem implants (BS-ABI) and subsequently presented with bilateral cerebrospinal fluid (CSF) leaks unresponsive to standard treatments. To propose a novel rigid retrosigmoid cranioplasty for treating and preventing CSF leaks in children at high risk for this complication. PATIENT: A 3.5-year-old child with CND, vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities, coloboma, heart defect, atresia choanae, retarded growth and development, genital abnormality, and ear abnormality, Arnold Chiari malformation, previous treated tracheo-esophageal fistula underwent BS-ABI. Postoperatively, the child had recurrent bilateral retroauricular fluid collections. A standard revision procedure revealed breaches in the dural closure, migration of the auditory brainstem implantation (ABI) receiver stimulator on both sides and was unsuccessful in stopping the leak. INTERVENTIONS: Bilateral repair with free fat grafting filling the craniectomy space and two absorbable meshes of poly-L-D-lactic (PLDL) acid stabilized with PLDL pins on the surrounding cranium, one to stabilize the fat graft and one to fix the ABI receiver stimulators inside the subperiosteal pockets. MAIN OUTCOME MEASURE: CSF leak recurrence, postoperative computed tomographic (CT) scans, intra- and postoperative simultaneous electrically evoked auditory brainstem responses (EABRs). Subjective and objective assessment of ABI function. RESULTS: No postoperative CSF leaks at 60 days follow-up. EABRs and consistent behavioral responses obtained at initial mapping on both sides. CONCLUSIONS: The use of BS-ABI likely contributed to bilateral CSF leaks requiring revision surgeries in this child. Simultaneous bilateral craniotomies can put patients at risk for CSF leak. A novel cranioplasty technique employed finally proved successful in stopping the CSF leak in this case

    Cavernous hemangioma: a term to be canceled

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    Many Authors still refer to “cavernous hemangioma”. To be correct, the term should indicate a tumor. Are cavernous hemangioma tumors? No. In a recent research Rootman et al. have demonstrated that CHs are non-infiltrating, focal venous malformations. They lack hyperplasia, that is, the cell turnover rate is not altered and they grow (when they do it, by an average 10 % per year) owing to phenomena of localized intravascular coagulation (LIC) and subsequent inflammation. Just like other Puig Type I venous malformations, they are (almost) excluded from the general circulation. Since isolated venous malformations of the orbit are not tumors, indications for surgery and, especially, the related informed consent must take this into consideration. Only those malformations presenting clear symptoms, like reduction in visual acuity and/or diplopia should be managed surgically. Another, less agreed on, indication is morphologically significant exophthalmos. Small, asymptomatic malformations, especially those located intraconally, can be just observed over time. Nonsurgical measures such as low molecular weight heparin could be used to stem episodes of LIC. Thus we believe that the term “cavernous hemangioma” should be canceled and replaced by Venous Malformation of the Orbit

    Cavernous hemangioma: a term to be canceled

    Get PDF
    Many Authors still refer to “cavernous hemangioma”. To be correct, the term should indicate a tumor. Are cavernous hemangioma tumors? No. In a recent research Rootman et al. have demonstrated that CHs are non-infiltrating, focal venous malformations. They lack hyperplasia, that is, the cell turnover rate is not altered and they grow (when they do it, by an average 10 % per year) owing to phenomena of localized intravascular coagulation (LIC) and subsequent inflammation. Just like other Puig Type I venous malformations, they are (almost) excluded from the general circulation. Since isolated venous malformations of the orbit are not tumors, indications for surgery and, especially, the related informed consent must take this into consideration. Only those malformations presenting clear symptoms, like reduction in visual acuity and/or diplopia should be managed surgically. Another, less agreed on, indication is morphologically significant exophthalmos. Small, asymptomatic malformations, especially those located intraconally, can be just observed over time. Nonsurgical measures such as low molecular weight heparin could be used to stem episodes of LIC. Thus we believe that the term “cavernous hemangioma” should be canceled and replaced by Venous Malformation of the Orbit

    Complications After Treatment of Head and Neck Venous Malformations With Sodium Tetradecyl Sulfate Foam

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    The aim of this study was to evaluate complications in patients with head and neck venous malformations (VMs) treated with foam sclerotherapy using sodium tetradecyl sulfate (STS)

    Complications After Treatment of Head and Neck Venous Malformations With Sodium Tetradecyl Sulfate Foam

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    The aim of this study was to evaluate complications in patients with head and neck venous malformations (VMs) treated with foam sclerotherapy using sodium tetradecyl sulfate (STS)

    Head and neck reconstruction with pedicled flaps in the free flap era.

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    Nowadays, the transposition of microvascular free flaps is the most popular method for management of head and neck defects. However, not all patients are suitable candidates for free flap reconstruction. In addition, not every defect requires a free flap transfer to achieve good functional results. The aim of this study was to assess whether pedicled flap reconstruction of head and neck defects is inferior to microvascular free flap reconstruction in terms of complications, functionality and prognosis. The records of consecutive patients who underwent free flap or pedicled flap reconstruction after head and neck cancer ablation from 2006 to 2015, from a single surgeon, in the AOUC Hospital, Florence Italy were analysed. A total of 93 patients, the majority with oral cancer (n = 59), were included, of which 64 were pedicled flap reconstructions (69%). The results showed no significant differences in terms of functional outcome, flap necrosis and complications in each type of reconstruction. Multivariate regression analysis of flap necrosis and functional impairments showed no associated factors. Multivariate regression analysis of complicated flap healing showed that only comorbidities remained an explaining factor (p = 0.019). Survival analysis and proportional hazard regression analysis regarding cancer relapse or distant metastasis, showed no significant differences in prognosis of patients concerning both types of reconstruction. In this retrospective, non-randomised study cohort, pedicled flaps were not significantly inferior to free flaps for reconstruction of head and neck defects, considering functionality, complications and prognosis

    The date mussel Lithophaga lithophaga: Biology, ecology and the multiple impacts of its illegal fishery

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    none8The date mussel Lithophaga lithophaga is an edible endolithic bivalve, protected by the EU Habitats Directive and other international agreements, living inside carbonate rocks. Its illegal harvesting is carried by breaking the rockswhere the bivalve grows. The impact has cascade consequences as it causes permanent changes in the substrate characteristics, the removal of benthic species, a shift from highly complex to structurally simplified habitats. As a result, the rich biodiversity of rocky reefs turns into a biological desert, named “barren”. Alongwith the over exploitation of fish, this practice leads to the increase of sea urchin density and grazing pressure on habitats, hampering the resilience of the associated biodiversity and functions. This paper summarizes the information on date mussel biology, ecology, ecotoxicology, fishery and the legal framework regulating its protection. Evidence indicates that illegal harvesting is still operated and widespread along the Mediterranean and has huge costs in terms of loss of natural capital and ecosystem services, and in terms of active ecological restoration. Two case study areas (the Sorrento and Salento peninsulas) were selected to assess the economic costs of this practice. Tangible economic costs in terms of ecosystems services' loss are huge (from ca. 35,000 to more than 400,000 euros/year in 6.6 km of Sorrento and ca. 1.8 million euros/year along the 69 km of Salento). These costs are, on average, ca. 30 times lower than those of ecosystem restoration. Data mining from websites indicates that date mussels are presently commercialized in hundreds of restaurants in Greece, Balkan countries, Spain and Italy, favoured also by the lack of appropriate consumer information. This practice should be controlled and contrasted at local scale, enforced by national legislations, and implemented by transnational initiatives. Social campaigns are needed to increase public awareness of the serious consequences of date-mussel fishery and consumptionopenAlberto Colletti; Beatrice Savinelli; Giorgia Di Muzio; Lucia Rizzo; Laura Tamburello; Simonetta Fraschetti; Luigi Musco; Roberto DanovaroColletti, Alberto; Savinelli, Beatrice; Di Muzio, Giorgia; Rizzo, Lucia; Tamburello, Laura; Fraschetti, Simonetta; Musco, Luigi; Danovaro, Robert

    Orbital medial wall fractures: Purely endoscopic endonasal repair with polyethylene implants

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    Our technique couples the stronger support granted by non-resorbable materials and the minimal invasiveness of the endoscopic approach without the need for long-term nasal packing

    Evaluación de la irradiación Gamma como método de conservación de frutas mínimamente procesadas: generando información para fomentar el consumo de productos irradiados

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    Las operaciones mecánicas como el cortado y pelado, limitan la vida útil de las frutas mínimamente procesadas, al acelerarse el proceso de maduración e incrementarse la susceptibilidad al pardeamiento enzimático y a la contaminación microbiana. Para prevenir estos problemas, la aplicación de tecnologías no térmicas representa una activa área de investigación. Por otra parte, se ha probado exitosamente la aplicación de irradiación gamma en productos frutihortícolas, para la inhibición de la brotación y del desarrollo microbiano, y el retraso de la maduración y senescencia. El Código Alimentario Argentino se modificó recientemente, promoviéndose la aplicación de esta tecnología en distintos productos, incluidas las frutas y hortalizas frescas (Cap. III, Art. 174, Resolución 13-E/2017). Sin embargo, evaluando esta aplicación, las experiencias son todavía escasas. Sumado a esto, los consumidores en general desconocen el uso y beneficios de la irradiación de alimentos, y algunos lo relacionan con efectos negativos sobre la salud, asociándolo con la radioactividad medicinal o actividad nuclear. Así, el objetivo de este trabajo fue evaluar el efecto de la aplicación de irradiación sobre la calidad y vida útil de duraznos mínimamente procesados para luego poder difundir los beneficios de la tecnología al consumidor.Fil: Colletti, Analía. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto Tecnología de Alimentos; Argentina. Agencia Nacional de Promoción Científica y Tecnológica (ANPCyT); Argentina.Fil: Denoya, Gabriela Inés. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto Tecnología de Alimentos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Budde, Claudio Olaf. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria San Pedro; Argentina.Fil: Horak, Celina. Comisión Nacional de Energía Atómica. Gerencia Aplicaciones Tecnológicas de Radiaciones; Argentina.Fil: Garitta, Lorena. Instituto Superior Experimental de Tecnología Alimentaria (ISETA). Departamento de Evaluación Sensorial de Alimentos; 9 de Julio. Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Polenta, Gustavo Alberto. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto Tecnología de Alimentos; Argentina
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