The Comprehensive Evaluation of the Pinch Deformity due to Concave Alar Cartilages and Its Management

Introduction: Acute angle between dome and ala causes alar concavity/pinch deformity. Breathing problems may accompany pinching. Here, pinch deformities were classified according to their severity and treatment modalities discussed. Materials and Methods: Rhinoplasty patients with pinch deformities were included in study. Pinching without external nasal valve blockage (ENVB) was classified mild, pinching with ENVB was classified moderate, and extreme pinching and ENVB were classified severe deformity. In mild deformity, cephalic resection of ala was performed or cephalic resection was combined with onlay graft over ala. In moderate deformity, cephalic part was bent and sutured over lower ala. In severe deformity, cephalic part was bent, and lateral strut graft was inserted between lower and cephalic ala. In pinch deformities combined with hypertrophic lower lateral cartilage (LLC), medial crural overlay preceded above-mentioned treatment modalities. Results: Thirty-eight patients (22 female, 16 male) with pinch deformities underwent rhinoplasty between January 2017 and December 2022. Mean age was 27 years. Mean follow-up was 32 months. Fifteen patients had mild deformities. Cephalic resection was enough in four patients. Camouflage grafts were settled over ala in eleven patients. Twenty patients had moderate deformities; cephalic ala was bent over lower part and sutured. Two patients had severe deformities; lateral strut graft was settled between lower and bent cephalic alar parts. One patient had LLC hypertrophy/pinch deformity. LLC hypertrophy was corrected by medial crural overlay, and concavity was corrected with cephalic resection. Satisfactory shape, better valve passage obtained in all cases. Conclusion: Pinch deformity could be classified according to its severity and appropriate treatment options could be determined for each class. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/journal/00266

Comparison of Patient Satisfaction Between Composite and Dorsum Augmentation-Only Nasal Reconstructions With Diced Cartilage Graft Wrapped in Fascia

The comparison of patient satisfaction with the use of diced cartilage graft wrapped in fascia (DCF) graft in composite versus dorsum augmentation-only reconstructions (DAOR), technical hints and complications in our series, affecting the end-result and the patient satisfaction (PS) has been presented

Correction to: Overview of therapeutic plasma exchange in pediatric neurology: a single-center experience (Acta Neurologica Belgica, (2018), 118, 3, (451-458), 10.1007/s13760-018-0961-5)

Unfortunately, the immediate following sentences were incorrectly published in Material and Method section of the original article. © 2018, Belgian Neurological Society

Çoklu Maksillomandibular Kistler Varlığında Ayırıcı Tanı: Gorlin-Goltz Sendromlu Bir Olgunun Sunumu

Giriş: Maksillomandibular kistler hastalarda sıklıkla karşılaşılan ve çoğu zaman da rastlantısal olarak saptanan yapılardır. Çoklu maksillomandibular çoklu kist varlığında özellikli sendromlar akla gelmelidir. Bu çalışmada, maksilla solunda ve mandibula tamamında kistler ile tarafımıza başvuran ve ileri incelemeler sonucunda Gorlin-Goltz Sendromu tanısı konan bir hasta sunulmuştur. Hasta ve Yöntem: On dokuz yaşında kadın, Ocak 2022’de alt çene bölgesinde şişlik sebebiyle dış merkezde diş hekimine başvurmuştur. Hastaya çekilen panoramik grafide maksilla ve mandibulada çoklu kistler saptanması üzerine hasta Plastik Rekonstrüktif ve Estetik Cerrahiye yönlendirilmiştir. Tarafımıza başvuran hastanın yapılan değerlendirmeleri sonucunda hastaya kist küretajı planlandı ve hasta ameliyat edildi. Bulgular: Ameliyat sırasında steril olması beklenen kemik içi bölgeden alınan örnekte Streptokok üremesi oldu ve hastaya sözkonusu etkene duyarlı antibiyoterapi başlandı. Ameliyat sırasında kistlerden alınan patoloji örneklerinde skuamöz epitel ile döşeli kistik oluşum, kronik iltihaplı epitelyal kistik oluşum ve keratinöz madde içeren kistik oluşum saptandı. Genç yaşta çoklu maksillomandibular kistleri olan hastada ön tanıda Gorlin-Goltz Sendromu düşünüldü ve hasta Deri ve Zührevi Hastalıklar polikliniğine yönlendirildi. Yapılan tüm vücut dermoskopisinde sırt orta hatta punch biyopsi ile teyit edilen yüzeyel yayılan bazal hücreli karsinom saptandı. Hastanın deri tümörünün geliştiği yaş ve yerleşim yeri ve hastanın çoklu maksillomandibular kistlerinin varlığı sebebiyle hasta, Gorlin-Goltz Sendromu lehine değerlendirildi. Sonuç: Maksillomandibular bölgede çoklu kistlerin mevcut olduğu genç hastalarda, olası deri lezyonlarının varlığı da araştırılmalıdır. Bu lezyonların birlikteliğinin saptandığı hastaların ayırıcı tanısında Gorlin-Goltz Sendromu unutulmamalıdır. Anahtar Kelimeler: Bazal hücreli karsinom, Gorlin-Goltz Sendromu, küretaj, mandibula kisti, maksilla kist

High pressure paint gun injury of the index finger: a case report

Injuries to the hand secondary to high pressure paint guns are considered to be true hand emergencies. These rare injuries may have serious outcomes, and a critical step in their management is extensive debridement performed within the first six hours following injury. For this reason, their diagnosis should not be delayed, and the hand surgeon should be informed immediately to initiate appropriate treatment. In this report, the authors describe a patient who was injured with a chemical paint gun, and whose injury was not diagnosed in the emergency department. The patient subsequently developed tenosynovitis. His treatment is reported herein

The Pronating Radius Osteotomy for Correcting the Supination Deformity in Brachial Plexus Birth Palsy

Objective: Severe supination deformity may be seen in brachial plexus birth palsy (BPBP). The aim of this study was to determine the efficacy of pronating radius osteotomy in the management of this deformity.Material and Methods: BPBP patients with severe supination deformity were included in this study and they were operated between November 2003 and December 2015, by the same operative team. Pronating radius osteotomy was performed and internal fixation was maintained either by Kirschner wires or semitubular plates. In some patients, tendon transfers were performed during the same operation for the restoration of shoulder and thumb abduction and wrist extension.Results: Forty one patients had supination deformities caused by BPBP. The mean age was 9.2 years (4-22). The mean follow-up was 5 years (1-7). The mean active pronation was -60° before the operation, and the passive one was -10°. The mean active pronation of the patients was 9° after the operation, and the passive one was 45°. The mean active supination of the patients was 75° before the operation, and the passive one was 85°. The mean active supination of the patients was 45° after the operation,and the passive one was 65°. One malunion was detected at the second year after the operation (1/41). Three patients had low pronation degrees during the follow-up (3/41).Conclusion: Satisfactory postural and functional improvement can be achieved with the use of pronating radius osteotomy for patients with severe supination contractures