Does partial expander deflation exacerbate the adverse effects of radiotherapy in two-stage breast reconstruction?

<p>Abstract</p> <p>Background</p> <p>The optimum protocol for expander volume adjustment with respect to the timing and application of radiotherapy remains controversial.</p> <p>Methods</p> <p>Eighteen New Zealand rabbits were divided into three groups. Metallic port integrated anatomic breast expanders of 250 cc were implanted on the back of each animal and controlled expansion was performed. Group I underwent radiotherapy with full expanders while in Group II, expanders were partially deflated immediately prior to radiotherapy. Control group did not receive radiotherapy.</p> <p>The changes in blood flow at different volume adjustments were investigated in Group II by laser Doppler flowmetry. Variations in the histopathologic properties of the irradiated tissues including the skin, capsule and the pocket floor, were compared in the biopsy specimens taken from different locations in each group.</p> <p>Results</p> <p>A significant increase in skin blood flow was detected in Group II with partial expander deflation. Overall, histopathologic exam revealed aggravated findings of chronic radiodermatitis (epidermal atrophy, dermal inflammation and fibrosis, neovascularisation and vascular changes as well as increased capsule thickness) especially around the lower expander pole, in Group II.</p> <p>Conclusions</p> <p>Expander deflation immediately prior to radiotherapy, may augment the adverse effects, especially in the lower expander pole, possibly via enhanced radiosensitization due to a relative increase in the blood flow and tissue oxygenation.</p

D-galaktoz ile oluşturulmuş yaşlanma modelinde doku faktörü aktivitesinin ve sialik asit miktarının değerlendirilmesi

D-galaktoz ile oluşturulmuş yaşlanma modelinde doku faktörü aktivitesinin ve sialik asit miktarının değerlendirilmes

Use of bilateral lateral nasal flaps sharing a single skin pedicle for repair of large midline nasal dorsum defects: A novel technique enabling maximal defect closure and minimal donor-site morbidity

Background: This study aimed to evaluate the utility of bilateral axial, lateral nasal flaps sharing a single skin pedicle in the reconstruction of large midline nasal dorsum defects. Materials and Methods: Six patients with large midline nasal dorsum defects due to tumor ablation (four basal cell carcinomas and two squamous cell carcinomas) were included in this study. Nasal defects were reconstructed by bilateral axial, lateral nasal flaps that easily reached nasal dorsal defect bilaterally. After the two parts of the flap were sutured on the dorsum of the nose, the donor area defects on each side of the flap were easily closed by pulling the cheek skin toward the flap sides. Results: After an average of 10 months of follow-up, the color and texture matches were good, and all the scars were at the borders of the esthetic units and symmetrical. Share of single pedicle by the two lateral nasal flaps enabled larger defect closure, and the likelihood of lengthening of the flap through the nasolabial sulcus bilaterally to enable the closure of nasal tip defects. Preparation of relatively smaller size flaps enables the formation of smaller defects in the donor site which could easily and safely be repaired with minimal complication risk. There were no complications related with the flaps or donor sites, except for venous congestion in one patient, and neither a tumor relapse nor a metastasis was detected. Conclusion: In conclusion, our findings revealed feasibility and safety of using bilateral axial, lateral nasal flaps sharing a single skin pedicle in repair of large midline nasal dorsum defects due to tumor ablation, which enables maximal defect closure and minimal donor-site morbidity

Myositis Ossificans Traumatica of the Medial Pterygoid Muscle After Third Molar Tooth Extraction: A Case Report and Review of Literature

Myositis ossificans (MO) is a rare non-neoplastic disorder characterized by heterotopic ossification in soft tissues, mainly muscles. MO traumatica is characterized by ossification of the soft tissues after acute or repetitive trauma, burns, or surgical intervention. Muscular or soft tissue trauma is usually present as the underlying etiology. MO traumatica usually involves the extremity muscles. The number of reported cases involving the masticatory muscles is extremely low. The most common clinical sign of this condition is progressive limitation of mouth opening. Surgical resection of the ossified tissue has been the most commonly used treatment for this disorder, with a high postoperative recurrence rate. We report a case of traumatic MO of the medial pterygoid muscle to draw attention to the possibility of the condition in patients with a limited mouth opening and to review the reported data about MO traumatica involving the medial pterygoid muscle. (C) 2018 American Association of Oral and Maxillofacial Surgeon

Arthrocentesis, Arthroscopic Assessment and Surgical Interventions

Temporomandibular joint disorders (TMJD) are not rare in the general population and the patients not responding to conservative therapies are candidates for surgery. Among surgical interventions, arthrocentesis, arthroscopic interventions and anatomic restoration via arthrotomy are the most popular methods. Any surgical intervention should aim to restore the TMJ, which is anatomically very complex and delicate. It should not be forgotten that the treatment of TMJD must be multidisciplinary and the preoperative conservative therapies should be continued postoperatively. Turk J Phys Med Rehab 2010;56 Suppl 1:29-33

Changes in pharyngeal (airway) morphology in Class III Turkish female patients after mandibular setback surgery

Introduction: The aim of this study was to evaluate changes in the pharyngeal and lower facial morphology in Turkish female Class III patients 1.5 +/- 0.4 years after mandibular setback surgery (bilateral sagittal split osteotomy), and orthodontic multi-bracket treatment. Only women with mandibular prognathism were selected because sex differences in pharyngeal airway changes were evident. Material and methods: Lateral cephalograms of 25 Turkish female Class III patients (mean age: 25.4 +/- 2.6 years) with mandibular prognathism, were assessed before and 1.5 +/- 0.4 years after operation. Paired t and Pearson tests were used. Results: The pharyngeal airway morphology showed significant changes in soft-palate length and posterior reference line (PRL) to point of posterior tongue. The decrease in PTV-Pg distance was correlated with the decreases in PRL-PSP, PRL-PTO and PRL-E distances. It was considered normal for the pharyngeal airway morphology to adapt after surgery to improve the hard tissue relationship. Conclusion: The lower facial morphology significantly changed and the pharyngeal airway narrowed 1.5 +/- 0.4 years after mandibular setback surgery. (C) 2008 European Association for Cranio-Maxillofacial Surgery