A rare truncal collateral lymph drainage pathway seen on indocyanine green lymphography in patients with secondary lower limb lymphedema

Objective: Although collateral lymphatic vessels are known to develop in patients with lymphedema, little is known about their significance. In this study, we investigated truncal collateral lymphatic drainage pathways in patients with lower limb lymphedema using indocyanine green (ICG) lymphography. Methods: The ICG fluorescence images and clinical characteristics of 80 consecutive patients (160 lower limbs) with secondary leg lymphedema who underwent ICG lymphography between September 2020 and September 2022 were retrospectively reviewed. Results: Seven patients were identified to have a truncal collateral lymphatic drainage pathway starting in the lateral abdomen and running in the direction of the ipsilateral axillary lymph nodes. These patients had particularly severe symptoms of lymphedema around the thigh or abdominal region or had genital lymphedema. Conclusions: A truncal collateral lymphatic drainage pathway may be associated with severe lower limb lymphedema, particularly if involving the genitals

Multiple Buttresses Reconstruction of Maxilla with Fibular Flap Using Computer-aided Design/Computer-aided Manufacturing after Maxillectomy

Background:. The maxilla comprises horizontal and vertical buttresses, each with specific functions, supporting various organs, such as the eyes, nose, and oral cavity. Notably, they combine to form a three-dimensional structure, which enables the buttresses to provide their inherent support strength. However, reconstructing the maxilla after maxillectomy by assembling new buttresses is challenging. We successfully reconstructed all the buttresses crucial for facial appearance and dental rehabilitation using a vascularized fibular flap. Methods:. Four patients underwent maxillary buttress reconstruction with a fibular flap after total or subtotal maxillectomy. We used computer-aided design/computer-aided manufacturing digital technology to osteotomize the fibula into multiple segments and assemble them to reconstruct the maxillary buttresses. Each buttress was assembled based on a preoperative simulation. Results:. All patients underwent immediate one-stage maxillary reconstruction. They had good maxillary buttress alignment and acquired good facial appearance, eye position, nasal airway, and prosthetically suitable maxillary alveolus ridge. Conclusions:. The combination of computer-aided design/computer-aided manufacturing digital technology and surgical techniques has enabled novel maxillary reconstruction, providing great hope to patients experiencing facial disfigurement and loss of function after maxillectomy

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

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