Trigger Site Inactivation for the Surgical Therapy of Occipital Migraine and Tension-type Headache: Our Experience and Review of the Literature

Background: Literature from the last decade has shown a correlation between resection of the occipital muscles and vessels and relief from migraine and tension-type headaches.Methods: The aim of this article was to describe the authors' technique to treat occipital migraine, while comparing our approach with the other currently available surgical options. Relevant anatomical issues and their implications in the surgical treatment of occipital migraine have been reviewed. We undertook a modified version of the currently used method of occipital migraine surgery. Patients completed questionnaires before and after surgery, and results were compared.Results: To identify all trigger points, we used a constellation of symptoms referred to by the patient rather than injection of botulinum toxin type A. The entire procedure was carried out under local anesthesia. In most of the patients (56) in whom a dilated/aneurysmal occipital artery was found, the procedure was limited to ligation of the occipital artery, with no further undermining of muscles or neurolysis, which reduced the invasiveness of the procedure.Conclusions: The main differences between our procedure and the currently used method were that (1) extensive undermining and muscular or nerve resection were not necessary and (2) no flap was transposed with the purpose of covering isolated nerves. Hence, our method could improve the currently used method, while minimizing its invasiveness

Breast reconstruction with anatomical implants: A review of indications and techniques based on current literature

One important modality of breast cancer therapy is surgical treatment, which has become increasingly less mutilating over the last century. Breast reconstruction has become an integrated part of breast cancer treatment due to long-term psychosexual health factors and its importance for breast cancer survivors. Both autogenous tissue-based and implant-based reconstruction provides satisfactory reconstructive options due to better surgeon awareness of \u201cthe ideal breast size\u201d, although each has its own advantages and disadvantages. An overview of the current options in breast reconstruction is presented in this article

Transcutaneous oximetry and laser Doppler flowmetry values in patients with chronic skin ulcers treated with platelet rich plasma and stromal vascular fraction cells: a pilot study

Background Stromal vascular fraction cells (SVFs) hold great promise for use in regenerative medicine applications, as a result of their ability to promote the healing process through in situ differentiation and the secretion of paracrine factors. The aim of this paper was to evaluate whether and how the topical application of SVF with platelet-rich plasma (PRP) for the treatment of chronic skin ulcers modified the cutaneous perfusion of the treated areas. Methods Perilesional laser Doppler flowmetry (LDF) and transcutaneous oximetry (tcpO2) values were recorded for a 3-month period in 15 patients with chronic skin ulcers of various etiologies, who had been previously treated with single co-administered perilesional and intralesional injections of SVF+PRP. Results No significant differences were found between pretreatment, 1 month, and 3 month posttreatment values regarding both LDF values (basal: p = 0.10 and declivous: p = 0.0976) and declivous tcpO2 levels (p = 0.0804). The only significant difference reported was between pretreatment and 3-month posttreatment basal tcpO2 levels (p = 0.0466). Conclusions These results may reflect improved subcapillary circulation of the treated areas at 3 months postinjection, without a significant improvement in capillary perfusion

Surgical therapy of cutaneous squamous cell carcinoma: our experience

Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer, with an excellent prognosis after surgical removal. However, nodal metastasis are present in about 5% of cases and the death rate is about 2%

Single center evidence for the treatment of basal cell carcinoma of the head and neck

AIM: Basal Cell Carcinoma (BCC) alone accounts for 80% of cases of non-melanoma skin cancer (NMSC), which characteristically develops on sun-exposed skin. Indeed the most common site of BCC is the head and neck region (80%). The purpose of this study to review the experience of our center with BCC in the head and neck region to report the sites of occurrence and treatment. MATERIALS AND METHOD: We retrospectively reviewed 77 patients with BCC of the head and neck, who revived surgical treatment within our plastic surgery division. Basic demographic data, cancer site and size, surgical treatment and histological data were collected. The mean follow-up period was 12 months. RESULTS: The study population included 37 males and 40 females, with a mean age of 74.12 years. The nasal unit was the main site of BCC (31.82%), followed by the periorbital (13.64%) and cervical (12.5%) units. Primary closure was the main surgical procedure performed (72.5%), followed by local flap (26.1%) and full-thickness skin grafts (1.4%). The safety resection margin ranged from 4.5 to 9 mm, with a 98.7% complete removal rate. Neither recurrence nor any newly-developed lesions were reported during follow-up in any patient. DISCUSSION: Our work reflects the shift in the incidence of BCC, which now seems to be more frequent in females. Furthermore, our data strengthens the association between UVR exposure and BCC, confirms its predilection to occur on the nasal unit and validates surgical excision as the gold standard treatment for skin cancer

Breast reconstruction with breast implants

Breast cancer is the most common noncutaneous malignancy among women worldwide. After a breast cancer removal procedure, women are asked to decide about breast reconstruction, mainly to improve their life quality, and they can choose from among many options. Broadly, there are two different types of breast reconstruction procedures: prosthetic implant-based reconstruction and autologous tissue-based reconstruction

Adipose-derived stem cells for treatment of chronic cutaneous ulcers in patients with critical limb ischemia: a pilot study

Therapeutic approaches based on stem cells have recently been introduced to treat chronic ulcers, with good results. The aim of this study was to evaluate whether the topical application of adipose-derived stem cells (ASCs) with platelet-rich plasma (PRP) for the treatment of ischemic cutaneous ulcers modified the skin perfusion of the treated areas. Perilesional laser Doppler flowmetry (LDF) and transcutaneous oximetry (tcpO(2)) values were recorded for a 3-month period in seven arteriopathic and diabetic patients with ischemic ulcers of the lower limb candidates to amputation, who had been previously treated with single co-administered perilesional and intralesional injections of ASCs+PRP. Significant differences were found between pretreatment (T0) and 3 month post-treatment (T3) values regarding both LDF values (basal mean values: T0 30.7; T3 50.4; declivous mean values: T0 23; T3 38.9;) and tcpO(2) levels (basal mean values: T0 6.7; T3 45.9; declivous mean values: T0 17.6; T3 47.3). According to the values of LDF and TcpO(2), the multidisciplinary treatment of severe ulcers with ACSs+PRP associated or not with revascularization therapy allowed a perilesional improvement of oxygenation and perfusion such to avoid limb amputation, with complete wound healing. Early treatment with ASCs associated or not with reperfusion therapy is an effective treatment even in severe ulcers in advanced stage once treated with amputation of limb