Bovine Dermal Matrix as Coverage of Facial Nerve Grafts

Introduction. Soft tissue defects over functional structures represent a challenge for the reconstructive surgeon. Often complex, reconstructive procedures are required. Occasionally, elderly or sick patients do not qualify for these extensive procedures. Case. We present the case of a 91-year-old lady with large hemifacial defect with exposed bone and nerves after tumor resection. We first performed radical resection including the fascia of the temporalis muscle and the frontal branch of the facial nerve. Due to the moribund elderly patient with a potentially high perioperative risk, we decided against flap reconstruction but to use bovine collagen/elastin matrix and split thickness skin graft. Results. No postoperative complications occurred and STSG and matrix healed uneventfully. Discussion. In selected cases, where complex reconstruction is not appropriate, this procedure can be a safe, easy, and fast alternative for covering soft tissue defects even on wound grounds containing nerve grafts

Osteolytic lesion in the greater trochanter mimicking tumor

Two patients with an osteolytic lesion of the greater trochanter suggesting a malignant bone tumor are presented. Biopsy, microbiological and histological examination suggested a diagnosis of trochanteric tuberculosis. Treatment consisted of multiple surgical debridements and antituberculous chemotherapy. The incidence of similar cases is expected to increase with the rising incidence of tuberculosi

Cotton-induced pseudotumor of the femur

Twenty-five years prior to presentation a 41-year-old man had a femoral fracture stabilized with a 4.5 mm AO/ASIF steel plate. The femur healed uneventfully and the patient was asymptomatic for the following 20 years. He then noticed a slow-growing swelling of the left thigh associated with a degree of weakness. Radiographs of the femur 25 years after fracture stabilization showed a massive expansive osteolytic process surrounded by a rim of bone. Magnetic resonance imaging (MRI) confirmed the presence of a large tumor. Since malignancy could not be excluded the patient underwent incisional biopsy. The histologic findings were nonspecific. Because of persistent symptoms the lesion was marginally excised. Intraoperatively a folded cotton sponge was found adjacent to the femur. Histopathologic investigation confirmed a foreign body reaction probably related to the retained cotton sponge. Reactive, foreign-body-induced change may mimic bone and or soft tissue malignancie

High-grade metachronous osteosarcoma. A case report over a 23-year period

This is a case report on the remarkable 23-year course of a metachronous osteogenic sarcoma in a 31-year-old man. Histology invariably showed the features of a high-grade osteogenic sarcoma with predominantly chondroblastic cells. During the observed period the patient developed nine osseous metastases. The quiescent clinical course of some metastases was in sharp contrast to the histological pattern. The patient finally died from symptoms of increasing cervical spinal cord compression without ever developing lung metastase

Validity and reliability of the CatWalk system as a static and dynamic gait analysis tool for the assessment of functional nerve recovery in small animal models

Introduction: A range of behavioral testing paradigms have been developed for the research of central and peripheral nerve injuries with the help of small animal models. Following any nerve repair strategy, improved functional outcome may be the most important evidence of axon regeneration. A novel automated gait analysis system, the CatWalk™, can measure dynamic as well as static gait patterns of small animals. Of most interest in detecting functional recovery are in particular dynamic gait parameters, coordination measures, and the intensity of the animals paw prints. This article is designed to lead to a more efficient choice of CatWalk parameters in future studies concerning the functional evaluation of nerve regeneration and simultaneously add to better interstudy comparability. Methods: The aims of the present paper are threefold: (1) to describe the functional method of CatWalk gait analysis, (2) to characterize different parameters acquired by CatWalk gait analysis, and to find the most frequently used parameters as well as (3) to compare their reliability and validity throughout the different studies. Results: In the reviewed articles, the most frequently used parameters were Swing Duration (30), Print Size (27), Stride Length (26), and Max Contact Area (24). Swing Duration was not only frequently used but was also the most reliable and valid parameter. Therefore, we hypothesize that Swing Duration constitutes an important parameter to be chosen for future studies, as it has the highest level of reliability and validity. Conclusion: In conclusion, CatWalk can be used as a complementary approach to other behavioral testing paradigms to assess clinically relevant behavioral benefits, with the main advantage that this system demonstrates both static and dynamic gait parameters at the same time. Due to limited reliability and validity of certain parameters, we recommend that only the most frequently assessed parameters should be used in the future

New posterior auricular perichondrial cutaneous graft for stable reconstruction of nasal defects

The perichondrial cutaneous graft (PCCG), a reliable composite graft that provides stability, is routinely harvested from the anterior conchal bowl. This established PCCG was simplified by using the less conspicuous posterior auricular donor site, which can be closed without the need of cartilage resection for reconstruction with a postauricular interpolated skin island. Patients with basal cell carcinoma of the nose underwent reconstruction of the nose with a PCCG if parts of the tip cartilage or the fibrofatty tissue were resected. The defect surface area was assessed with a template. Follow-up evaluation included assessment of graft survival, donor-site morbidity, nostril stability, and aesthetic outcome. Of the 14 patients included in the study, whose average defect sizes were 2 cm2 (ala) and 2.5 cm2 (tip), 79% showed primary complete healing. Nostril stability was symmetrical 6 months postoperatively, and no contractions or depressed contour had occurred. In one case, a hyperpigmented area resulted in a slightly imperfect color match. All the donor sites healed without deformity or destabilization of the ear. With the use of this new posterior auricular donor site for graft harvest, functional, stable, and aesthetic reconstruction of the nose can be achieved. The graft- and donor-site morbidity rates are very low, and the results are fully satisfyin