137 research outputs found
Experimental evidence in hair restoration procedures: Plucked hair survival and growth rate
Background: limitations of hair restoration procedures are the amount of hairs available and the invasiveness of follicular harvesting. Objective: The aim of this study was to compare conventional human micrografts and plucked hair follicles in an in vitro model in order to test hair growth rates for experimentally assessing the soundness of plucked follicle use in hair transplantation procedures. Methods and materials: A total of 100 conventional one-hair micrografts (group A; control) and a total of 80 plucked hair follicles (group B; experimental) were obtained from 14 healthy male patients. The length of each graft was measured immediately following isolation and at the end of the 10-day culture period. The Kruskal-Wallis one-way analysis of variance by ranks test was used in order to statistically analyze the data obtained. Results: A statistically significant difference was found between the growth rate of micrografts in control (mean 10-day shaft growth rate = 0.30mm) and experimental (mean 10-day shaft growth rate = 0.36mm) groups. Conclusion: The obtained data shows a higher plucked hair follicle growth rate compared to one-hair micrografts, which leads us to believe that plucked micrografts could be a useful and less invasive adjunct in the field of hair transplantation surgery
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
Surgical Therapy of Migraine and Tension-Type Headache
During the last few years, multiple studies have demonstrated the efficacy of migraine and tension-type headache trigger site deactivation surgery, hence expanding the therapeutic potentiality of plastic surgery. These procedures are performed based on headache onset and location: four trigger points that may cause the compression of the trigeminal branches have been described. In the present chapter, we describe indications, contraindications, procedures, and results of this therapy, focusing on our approach that relies on one 1-cm incision, and it is performed under local anesthesia
Tissue expansion for breast reconstruction: Methods and techniques
Objective In this work, the authors review recent data on the different methods and techniques of TE/implant-based reconstruction to determine the complication profiles and the advantages and disadvantages of the different techniques. This information will be valuable for surgeons performing breast reconstructions. Materials and methods A thorough literature review was conducted by the authors concerning the current strategy of tissue expander (TE)/implant-based breast reconstruction following breast cancer surgery. Results Loss of the breast can strongly affect a woman's personal and social life while breast reconstruction reduces the sense of mutilation felt by women after a mastectomy, and provides psychosocial as well as aesthetic benefits. TE/implant-based reconstruction is the most common breast reconstructive strategy, constituting almost 65% of all breast reconstructions in the US. Although numerous studies have been published on various aspects of alloplastic breast reconstructions, most studies are single-center observations. No evidence-based guidelines are available as yet. Conventional TE/implant-based reconstruction can be performed as a two-stage procedure either in the immediate or delayed setting. Moreover, the adjunctive use of acellular dermal matrix further broadened the alloplastic breast reconstruction indication and also enhanced aesthetic outcomes. Conclusions TE/implant-based reconstruction has proved to be a safe, cost-effective, and reliable technique that can be performed in women with various comorbidities. Short operative time, fast recovery, and absence of donor site morbidity are other advantages over autologous breast reconstruction
Minimally Invasive Surgical Treatment of Migraine
Migraine headache (MH) is a very common disorder affecting 10–12% of the world’s adult population. The first line therapy for migraine is usually a combination of conservative treatments but some patients seem to be refractory. For this group of patients, the minimally invasive surgical treatment of migraine might offer a solution. Migraine is usually caused by extracranial sensitive nerve compression due vascular, fascial or muscular structures nearby. The aim of migraine surgery is to relieve such compression at specific trigger points located in the occipital, temporal and frontal regions. From June 2011 until July 2019, we performed MH decompression surgeries in over 269 patients with either frontal, occipital, or temporal migraine trigger sites. In the occipital and temporal areas, nerve decompression was achieved by occipital and superficial temporal artery ligation, respectively. In patients suffering from frontal headache we performed both endoscopic nerve decompression and transpalpebral decompression. Among patient suffering from occipital migraine, 95% of them showed improvement of their condition, with 86% reporting complete relief. As concern temporal migraine, positive outcome was achieved in 83% of the patients (50% complete elimination and 33% partial improvement). In patient suffering from frontal migraine, positive results were observed in 94% of the patients (32% complete elimination, 62% partial improvement). Migraine is a common and debilitating condition that can be treated successfully with minimally invasive surgical procedure especially for those patients non-responding to medical therapies
Ultrastructural imaging reveals vascular remodeling in migraine patients
Migraine is a neurological disorder and one of the most common pain conditions worldwide. Despite its prevalence, the basic biology and underlying mechanisms contributing to the development of migraine are still poorly understood. It is still unclear, for instance, whether the vasculature, both extra and intracranial, plays a significant role in the generation of migraine pain. Neuroimaging data, indeed, have reported conflicting results on blood vessels abnormalities like vasodilation, while functional studies suggest that vessels dysfunction may extend beyond vasodilation. Here we combined light and electron microscopy imaging to investigate the fine structure of superficial temporal (STA) and occipital arteries (OA) from patients that underwent minimally invasive surgery for migraine. Using optical microscopy, we observed that both STA and OA vessels showed marked endothelial thickening and internal elastic lamina fragmentation. In the muscular layer, we found profound shape changes of vascular smooth muscle cells (VSMCs), abundant extracellular matrix, and the presence of clear extracellular vacuoles. The electron microscopy analysis confirmed putative VSMCs infiltrated within the intima layer and revealed a consistent shifting of VSMCs from contractile to a synthetically active phenotype. We also report the presence of (i) abundant extracellular vacuoles filled with fine granular material and membranes, (ii) multilamellar structures, (iii) endosome-like organelles, and (iv) bona fide extracellular vesicles in the matrix space surrounding synthetically active cells. As both the endothelial layer and VSMCs coordinate a variety of vascular functions, these results suggest that a significant vascular remodeling is occurring in STA and OA of migraine patients. Thus, this phenomenon may represent an important target for future investigation designed toward the development of new therapeutic approaches
The medical historical cultural foundations of western nasal surgery from ancient greece to the middle ages
The manuscript aims to clarify the origins of Western rhinosurgery through the ancient texts of the greatest physicians of the past, up to the Byzantine Era, focusing on the "exchange of knowledge" between peoples. This excursus is carried out by quoting the texts of the greatest doctors of the past, such as Hippocrates, Galen and Celsus and by analysing the works of Byzantine authors such as Oribasius, Aetius, Antillus, which, more than others, represent the moment of fusion and interpenetration of Ancient Medical knowledge, paving the way for the Medieval Scholae Medicae in the West. The aim, therefore, is to fill that sort of "great gap" (from the foundation of Constantinople in the 4th century AD to the early Arab culture in the 11th century AD) due to the fact that figures such as Branca, Vianeo and, finally, Tagliacozzi, are considered direct actors of a recovery of the "ancient knowledge" of classic authors. This literature tends to less evaluate, instead, that important and huge cultural exchange -literally osmotic- in medical and surgical knowledge between peoples and civilizations, that find a trait d'union in the application of medical knowledge and surgical practical techniques matured in the Byzantine, Arab and Early Medieval period. In final analysis, through the History of Rhinosurgery, this paper aims to highlight how Western medical knowledge is made up of the ensemble of cultures which are apparently distant and different from each other, which merge themselves in a truly universal and transcultural knowledge: the Medical knowledge
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
Spectrophotometric technology for the early detection of cutaneous melanoma
This paper presents the design and experimental outcomes of an ongoing research project aimed at the early detection of melanoma by means of a new diagnostic device. This device, based on the principles of spectrophotometry, is expected to improve upon the current diagnostic methods, which are known to carry a margin of error quantified as 10-20%. This article presents the implemented technology, in the form of two scanning prototypes, the current experimental work, and the analysis procedures leading to the development of a diagnostic model based upon the spectral representation of pigmented lesions
Il Melanoma Cutaneo. Diagnosi e Terapia Chirurgica
none1noneRaposio EdoardoRaposio, Edoard
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