Computerised 3D evaluation of the functional eyelid deficit in facial palsy.

Facial palsy is often characterised by a severe dysfunction of the eyelids, leading to corneal ulceration and even blindness. A precise evaluation of the exposed ocular surface is very important in order to estimate the risks of these ocular symptoms. In the literature, most authors use a comparison between the heights of lagophthalmus and corneal exposure in the pre- and postoperative situations to evaluate the surgical correction of the eyelids in facial paralysis. The heights are not representative of the real exposed surfaces. We propose another method to evaluate these surfaces, using a computer-assisted design (CAD) software analysing standardised photographs and giving a precise assessment of the surface of the eye not covered by the eyelids. The exposed surface is more representative of the risks of ocular symptoms than the height. Our goal in this study was to improve the quality of the measurements, which allows to get a better estimation of the clinical situation and provides a tool that permits comparison of results between different surgical approaches.Journal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Prebiliary Right Hepatic Artery Resulting in Common Hepatic Duct Compression and Subsequent Intrahepatic Stone Formation: Myth or Reality?

The vascular anatomy of the liver is subjected to many variations. Aberrant hepatic artery is not an uncommon finding during visceral surgery; however, topographic variations are less reported in the literature. Prebiliary artery crossing anteriorly to the common hepatic duct was firstly reported in 1984. We present here a case of a 52-year-old lady who presented with obstructive jaundice and right upper quadrant pain. Paraclinical investigations were consistent with intrahepatic stones and a benign stricture on the CBD. During surgery, a prebiliary right hepatic artery compressing the CHD was noted. The liver pedicle was dissected and a hepaticojejunostomy was performed that resulted in a good outcome after 24 months of followup

Complicated rectovaginal fistula secondary to Bartholin's cyst infection

Rectovaginal fistula formation secondary to Bartholin's cyst is a very rare complication, and to date only three cases were reported in the literature.We report a case of a 32-year-old woman who suffered recurrent episodes of Bartholin's cyst infection with subsequent abscess formation that resulted in rectovaginal fistula formation. We treated her initially with transperineal repair; however, the fistulous tract recurred a month later. A laparoscopic colostomy and transperineal repair using biological graft was then performed, with excellent results. The patient underwent reversal of colostomy after 2 months, and remained asymptomatic upon follow-up 12 months later. © 2014 Japan Society of Obstetrics and Gynecology.SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe

Gastric outlet obstruction - looking for a syndrome: Bouveret or Mirizzi?

Introduction and importance: Gastric outlet obstruction can result from any pathological process that causes intrinsic blockage or extrinsic pressure on the distal stomach and duodenum. Gallstone related gastric outlet obstruction is a well-known entity classically due to a cholecystoenteric fistula formation. Case presentation: We present here a case of a 36-year-old man who presented with right upper quadrant abdominal pain associated with marked nausea and vomiting. Abdominal CT scan done in the emergency department revealed a large impacted infundibular gallstone with signs of acute cholecystitis, associated with prominent gastric distention. Gastric outlet obstruction was due to stenosis at the duodenal level from external compression by the large impacted stone with no evidence of fistula. Laparoscopic cholecystectomy was performed with total resolution of symptoms. Clinical discussion: Gastric outlet obstruction can be secondary to many etiologies, and notably gallstone disease. Classically this is due to formation of a cholecystoenteric fistula and intrinsic obstruction by the migrated stone. Our case is unique in that a large impacted infundibular gallstone caused gastric outlet obstruction with absence of any fistula or gallstone migration. Conclusion: Gastric outlet obstruction due to external compression by a non-migrated gallstone is a rare undescribed entity. Surgical treatment should not be delayed to prevent complications and fistula formation.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Mind the Gap: A Questionnaire on the Distance between Diagnostic Advances and Clinical Practice in Skin Cancer Treatment

Background and Objectives: Significant progress has been made in skin cancer diagnosis, with a surge in available technologies in recent years. Despite this, the practical application and integration of these technologies in dermatology and plastic surgery remain uneven. Materials and Methods: A comprehensive 20-question survey was designed and distributed using online survey administration software (Google Forms, 2018, Google, Mountain View, CA, USA) from June 2023 to September 2023. The survey aimed to assess the knowledge and utilization of dermatologic diagnostic advancements among plastic surgeons in various European countries. Results: Data were obtained from 29 plastic surgeons across nine European countries, revealing a notable gap between diagnostic technologies and their routine use in surgical practice. The gap for some technologies was both cognitive and applicative; for electrical impedance spectroscopy (EIS) and multispectral imaging, only 6.9% of the sample knew of the technologies and no surgeons in the sample used them. In the case of other technologies, such as high-frequency ultrasound (HFUS), 72.4% of the sample knew about them but only 34.5% used them, highlighting a more significant application problem. Conclusions: Spotlighting this discrepancy provides a valuable foundation for initiating collaborative efforts between units and facilitating knowledge exchange among diverse specialists. This, in turn, contributes to advancing clinical practice by integrating the innovative opportunities presented by ongoing research.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Different laparoscopic treatment modalities for splenic artery aneurysms: about 3 cases with review of the literature

Introduction: The first laparoscopic treatment of splenic artery aneurysm (SAA) was performed in 1993. Since then, many papers have been published mentioning different laparoscopic treatment modalities, including splenectomy, aneurysmectomy, ligation or even occlusion. Patients and methods: An updated literature review of the English medical literature using the following MeSH, ‘Lapaorscopic splenic artery aneurysm’, ‘laparoscopic aneurysectomy’, ‘Laparoscopic Splenic artery Aneurysm Ligation’ and ‘Laparoscopic Splenic artery aneurysm excision’ was done. Also three cases performed at our institutions are discussed, in terms of techniques, morbidity, mortality and postoperative outcomes. Results: About eight case series and 16 case reports were retrieved from the literature. Different techniques were described by the authors, including splenectomy, aneurysmectomy, splenic aneurysm ligation or even occlusion. Few morbidity cases were reported and none of the authors has mentioned a single mortality case. In our three cases, the postoperative course was uneventful, with good long-term results. Conclusions: Despite the variations in the adopted operative techniques, the laparoscopic approach seems to be harmless. However, no treatment algorithm or consensus has been published.SCOPUS: re.jinfo:eu-repo/semantics/publishe