Pub Date : 2025-02-07DOI: 10.1016/j.jpra.2025.02.005
Tuan Ngoc Le , Hung Phuoc Do , Phi Duong Nguyen
This study investigates the anatomy and biomechanics of the scapholunate ligament in Vietnamese cadavers. Measurements reveal population-specific dimensions and tensile strength, providing valuable insights for clinical management of wrist instability and guiding future research in orthopedic applications.
{"title":"Anatomy and biomechanics of the scapholunate ligament in Vietnamese cadavers","authors":"Tuan Ngoc Le , Hung Phuoc Do , Phi Duong Nguyen","doi":"10.1016/j.jpra.2025.02.005","DOIUrl":"10.1016/j.jpra.2025.02.005","url":null,"abstract":"<div><div>This study investigates the anatomy and biomechanics of the scapholunate ligament in Vietnamese cadavers. Measurements reveal population-specific dimensions and tensile strength, providing valuable insights for clinical management of wrist instability and guiding future research in orthopedic applications.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"44 ","pages":"Pages 18-21"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jpra.2025.01.020
Joshua M. Cohen , Geena Jung , Hailey Reisert , Yi-Hsueh Lu , Genesis Liriano , Bradley A. Schiff , Evan S. Garfein , Andrew J. Kobets
Giant cell tumors (GCTs) are common benign bone tumors found in young adults, frequently occurring in the long bones but rarely in the skull. Although considered benign, GCTs have the potential to be aggressive, destroying surrounding tissue. Here, we present the unusual case of a patient with a GCT of the middle ear and skull base. A 19-year-old male with an extensive giant cell tumor underwent surgical resection by a multidisciplinary team consisting of otolaryngology, neurosurgery, and plastic and reconstructive surgery. The mass was grossly resected, and a cervicofacial flap allowed for reconstruction with optimal cosmesis, a procedure not described for GCTs. This approach allowed for excellent wound healing without tumor recurrence. Gross total resection remains the most effective treatment for GCTs, minimizing radiation exposure and recurrence risk. However, an optimal surgical approach for skull GCTs has yet to be described. Skull-base GCTs present a challenge due to their complex anatomy and neurovascular elements. Further, the high rates of local recurrence make gross resection the goal of treatment, though this is difficult to achieve. The present case was successfully managed by extensive multidisciplinary surgical resection, highlighting the necessity of collaborative effects to achieve gross total resection and positive aesthetic outcomes.
{"title":"Rare presentation and resection of giant cell tumor invading the middle ear and skull base: A case report","authors":"Joshua M. Cohen , Geena Jung , Hailey Reisert , Yi-Hsueh Lu , Genesis Liriano , Bradley A. Schiff , Evan S. Garfein , Andrew J. Kobets","doi":"10.1016/j.jpra.2025.01.020","DOIUrl":"10.1016/j.jpra.2025.01.020","url":null,"abstract":"<div><div>Giant cell tumors (GCTs) are common benign bone tumors found in young adults, frequently occurring in the long bones but rarely in the skull. Although considered benign, GCTs have the potential to be aggressive, destroying surrounding tissue. Here, we present the unusual case of a patient with a GCT of the middle ear and skull base. A 19-year-old male with an extensive giant cell tumor underwent surgical resection by a multidisciplinary team consisting of otolaryngology, neurosurgery, and plastic and reconstructive surgery. The mass was grossly resected, and a cervicofacial flap allowed for reconstruction with optimal cosmesis, a procedure not described for GCTs. This approach allowed for excellent wound healing without tumor recurrence. Gross total resection remains the most effective treatment for GCTs, minimizing radiation exposure and recurrence risk. However, an optimal surgical approach for skull GCTs has yet to be described. Skull-base GCTs present a challenge due to their complex anatomy and neurovascular elements. Further, the high rates of local recurrence make gross resection the goal of treatment, though this is difficult to achieve. The present case was successfully managed by extensive multidisciplinary surgical resection, highlighting the necessity of collaborative effects to achieve gross total resection and positive aesthetic outcomes.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 544-550"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-31DOI: 10.1016/j.jpra.2025.01.021
Alexander F. Dagi, Michael B. Amrami, Nikhil A. Gangoli, Dylan K. Kim, Jarrod T. Bogue
Six clinical databases were analysed from inception through 2023 to assess the trajectory of orthoplastic surgery research and provide a scoping review of concentrations and gaps in the literature. The literature grew exponentially since 2010, with 66 % of identified studies published between 2020 and 2024. The United Kingdom emerged as the primary contributor, accounting for 47 % of publications following national guideline implementation that demonstrated improved patient outcomes. While meta-analyses support the clinical benefits of orthoplastic management for complex fractures, showing reduced surgical interventions and infection rates, the evidence base relies predominantly on retrospective studies, with no randomized controlled trials identified. Key opportunities to strengthen the field include conducting prospective studies, expanding research beyond lower extremity trauma to areas such as upper extremity reconstruction, oncologic applications, and paediatric care, addressing healthcare access disparities, evaluating cost-effectiveness across different healthcare systems, and developing standardized guidelines beyond the UK.
{"title":"Orthoplastic surgery research: Three decades of growth and future directions","authors":"Alexander F. Dagi, Michael B. Amrami, Nikhil A. Gangoli, Dylan K. Kim, Jarrod T. Bogue","doi":"10.1016/j.jpra.2025.01.021","DOIUrl":"10.1016/j.jpra.2025.01.021","url":null,"abstract":"<div><div>Six clinical databases were analysed from inception through 2023 to assess the trajectory of orthoplastic surgery research and provide a scoping review of concentrations and gaps in the literature. The literature grew exponentially since 2010, with 66 % of identified studies published between 2020 and 2024. The United Kingdom emerged as the primary contributor, accounting for 47 % of publications following national guideline implementation that demonstrated improved patient outcomes. While meta-analyses support the clinical benefits of orthoplastic management for complex fractures, showing reduced surgical interventions and infection rates, the evidence base relies predominantly on retrospective studies, with no randomized controlled trials identified. Key opportunities to strengthen the field include conducting prospective studies, expanding research beyond lower extremity trauma to areas such as upper extremity reconstruction, oncologic applications, and paediatric care, addressing healthcare access disparities, evaluating cost-effectiveness across different healthcare systems, and developing standardized guidelines beyond the UK.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 506-509"},"PeriodicalIF":1.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-30DOI: 10.1016/j.jpra.2025.01.016
Juliënne A. Berben , Esther M. Heuts , Thiemo J.A. van Nijnatten , René R.W.J. van der Hulst
Introduction
Silicone lymphadenopathy (SLA) is a known finding after breast implant surgery. The prevalence of SLA is unknown and therefore its clinical implications are unclear. To make a statement about the clinical importance of SLA, more knowledge on its prevalence is necessary. This study aimed to provide details of SLA prevalence in a single-center.
Methods
This single-center retrospective cohort collected all breast radiology reports from breast or axillary ultrasound (US) and breast MRI exams between 2010 and 2020. These reports were screened for the presence of implant rupture (IR) and/or SLA.
Results
Overall, 1,217 women with silicone breast implants (SBIs) were included over 10 years. This resulted in 1,345 US and 900 MRI reports. In this cohort, 47 women (3.86%) had SLA with intact SBIs, 136 women (11.18) had IR, and 24 (1.97%) had SLA with IR. The sensitivity for IR on US and MRI were 76.2% and 91.7%, respectively. The specificity was 53.8% for IR on US and 66.7% on MRI. These calculations were based on the imaging results of patients whose implants were removed in the MUMC+.
Conclusion
This retrospective cohort provides a single-center ten-year representation of diagnostic imaging of patients with breast implants. The prevalence of SLA in this cohort of women with breast implants is 5.83%. IR increases the risk of developing SLA; however, it can also occur in women with intact SBIs. To our knowledge, this is the first study to report on the prevalence of SLA in patients with SBIs.
{"title":"Prevalence of Silicone Lymphadenopathy in Women with Breast Implants: A single-center retrospective study","authors":"Juliënne A. Berben , Esther M. Heuts , Thiemo J.A. van Nijnatten , René R.W.J. van der Hulst","doi":"10.1016/j.jpra.2025.01.016","DOIUrl":"10.1016/j.jpra.2025.01.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Silicone lymphadenopathy (SLA) is a known finding after breast implant surgery. The prevalence of SLA is unknown and therefore its clinical implications are unclear. To make a statement about the clinical importance of SLA, more knowledge on its prevalence is necessary. This study aimed to provide details of SLA prevalence in a single-center.</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort collected all breast radiology reports from breast or axillary ultrasound (US) and breast MRI exams between 2010 and 2020. These reports were screened for the presence of implant rupture (IR) and/or SLA.</div></div><div><h3>Results</h3><div>Overall, 1,217 women with silicone breast implants (SBIs) were included over 10 years. This resulted in 1,345 US and 900 MRI reports. In this cohort, 47 women (3.86%) had SLA with intact SBIs, 136 women (11.18) had IR, and 24 (1.97%) had SLA with IR. The sensitivity for IR on US and MRI were 76.2% and 91.7%, respectively. The specificity was 53.8% for IR on US and 66.7% on MRI. These calculations were based on the imaging results of patients whose implants were removed in the MUMC+.</div></div><div><h3>Conclusion</h3><div>This retrospective cohort provides a single-center ten-year representation of diagnostic imaging of patients with breast implants. The prevalence of SLA in this cohort of women with breast implants is 5.83%. IR increases the risk of developing SLA; however, it can also occur in women with intact SBIs. To our knowledge, this is the first study to report on the prevalence of SLA in patients with SBIs.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"44 ","pages":"Pages 1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-29DOI: 10.1016/j.jpra.2025.01.017
P. Manchon-Walsh , R. Clèries , R. Font , J. Solà , C. Casanovas-Guitart , A. Guarga , A.B. López-Ojeda , M.J. Pla , J.A. Espinàs , J.M. Borràs
Background
The number of post-mastectomy breast reconstructions performed in patients with breast cancer varies widely. This study aimed to assess geographic and temporal variability and associated factors from 2018 to 2020, including the effect of the COVID-19 pandemic.
Methods
This population-based cohort study was conducted in women who underwent mastectomy for invasive breast cancer from 2018 to 2020 in the Catalan public healthcare system, with follow-up until November 2022. Data were drawn from the Catalan hospital discharge registry. Random-effects logistic regression was performed to identify individual, temporal, and center-based variables influencing breast reconstruction and to assess the associations with immediate versus delayed reconstruction.
Results
Among the 4315 included patients, 2173 (50.4%) underwent breast reconstruction (range by center 0% to 79%); 1750 (80.5%) surgeries were immediate and 423 (19.5%) were delayed. Significant, negative associations were older age, heart disease, kidney disease, and metastasis. Microsurgery and the R2 health region showed positive associations (odds ratio [OR] 4.67, 95% credible intervals [CrI] 1.73-13.63). Surgeries were immediate in 0% to 99% of the cases, according to center. Age was unrelated; however, microsurgery (OR 7.15, 95% CrI 1.92-29.34) and belonging to health region R5 (OR 47.88, 95% CrI 1.67-99.0) were related. Compared to 2018, rates of reconstructive surgery were similar to those in 2019 (OR 0.98, 95% CrI 0.81-1.18) and 2020 (OR 0.94, 95% CrI 0.77-1.14), whereas immediate reconstruction was more common (2019: OR 1.72, 95% CrI 1.30-2.27; 2020: OR 4.85, 95% CrI 3.44-6.84).
Conclusions
Age, comorbidities, and microsurgery help explain between-center variability in breast reconstruction, while its timing appeared to be influenced by microsurgery alone. The pandemic may have accelerated the trend toward immediate surgery.
{"title":"Microsurgery influences breast reconstruction and its timing in patients with breast cancer: A population-based multilevel analysis","authors":"P. Manchon-Walsh , R. Clèries , R. Font , J. Solà , C. Casanovas-Guitart , A. Guarga , A.B. López-Ojeda , M.J. Pla , J.A. Espinàs , J.M. Borràs","doi":"10.1016/j.jpra.2025.01.017","DOIUrl":"10.1016/j.jpra.2025.01.017","url":null,"abstract":"<div><h3>Background</h3><div>The number of post-mastectomy breast reconstructions performed in patients with breast cancer varies widely. This study aimed to assess geographic and temporal variability and associated factors from 2018 to 2020, including the effect of the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>This population-based cohort study was conducted in women who underwent mastectomy for invasive breast cancer from 2018 to 2020 in the Catalan public healthcare system, with follow-up until November 2022. Data were drawn from the Catalan hospital discharge registry. Random-effects logistic regression was performed to identify individual, temporal, and center-based variables influencing breast reconstruction and to assess the associations with immediate versus delayed reconstruction.</div></div><div><h3>Results</h3><div>Among the 4315 included patients, 2173 (50.4%) underwent breast reconstruction (range by center 0% to 79%); 1750 (80.5%) surgeries were immediate and 423 (19.5%) were delayed. Significant, negative associations were older age, heart disease, kidney disease, and metastasis. Microsurgery and the R2 health region showed positive associations (odds ratio [OR] 4.67, 95% credible intervals [CrI] 1.73-13.63). Surgeries were immediate in 0% to 99% of the cases, according to center. Age was unrelated; however, microsurgery (OR 7.15, 95% CrI 1.92-29.34) and belonging to health region R5 (OR 47.88, 95% CrI 1.67-99.0) were related. Compared to 2018, rates of reconstructive surgery were similar to those in 2019 (OR 0.98, 95% CrI 0.81-1.18) and 2020 (OR 0.94, 95% CrI 0.77-1.14), whereas immediate reconstruction was more common (2019: OR 1.72, 95% CrI 1.30-2.27; 2020: OR 4.85, 95% CrI 3.44-6.84).</div></div><div><h3>Conclusions</h3><div>Age, comorbidities, and microsurgery help explain between-center variability in breast reconstruction, while its timing appeared to be influenced by microsurgery alone. The pandemic may have accelerated the trend toward immediate surgery.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 518-532"},"PeriodicalIF":1.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-25DOI: 10.1016/j.jpra.2025.01.014
Satoshi Onoda , Kahori Tsukura , Ken Takeda
Aim
We developed a simple bipolar skin and subdermal hemostasis technique called the “Skin Subdermal Adhesion Technique” (SAT), which prevents postoperative complications and provides good cosmetic results.
Patients and Methods
We performed 40 ptosis surgeries in 20 patients using SAT. All patients underwent bilateral excision of the excess skin due to age-related upper eyelid skin laxity; patients with facial nerve palsy and those who underwent manipulation of the levator muscle were excluded. The maximum wound width of the defect after skin resection and diameter after SAT were measured. Additionally, the presence or absence of postoperative complications requiring additional surgeries or procedures was investigated.
Results
The mean (range) age was 76.0 (55–86) years. Among the bilateral resection widths, the diameter of the wider side was 11–20 mm (mean, 14.85±2.67 mm). In contrast, the defect width after SAT was 8–13 mm (mean, 9.75±1.84 mm). SAT reduced the maximum width by 34.3%. There were no cases of postoperative complications, such as wound hematoma formation or infection.
Conclusion
SAT is useful for treating upper eyelid skin defects because it does not require any special equipment, is quick to perform, reduces the risk of postoperative complications such as hematoma, and provides good cosmetic results.
目的我们开发了一种简单的双极皮肤和皮下止血技术，称为 "皮肤皮下粘附技术"（SAT），它可以防止术后并发症，并提供良好的美容效果。患者和方法我们使用 SAT 为 20 名患者实施了 40 例上睑下垂手术。所有患者均接受了双侧上睑皮肤松弛多余皮肤切除术；排除了面神经麻痹患者和接受提上睑肌操作的患者。测量皮肤切除后缺损的最大伤口宽度和 SAT 后的直径。此外，还调查了术后有无需要进行额外手术或程序的并发症。在双侧切除宽度中，较宽一侧的直径为 11-20 毫米（平均为 14.85±2.67 毫米）。相比之下，SAT术后的缺损宽度为8-13毫米（平均为9.75±1.84毫米）。SAT 使最大宽度减少了 34.3%。结论SAT是治疗上眼睑皮肤缺损的有效方法，因为它不需要任何特殊设备，操作快捷，降低了血肿等术后并发症的风险，并提供了良好的美容效果。
{"title":"Skin subdermal adhesion technique for upper blepharoplasty treatment for dermatochalasis","authors":"Satoshi Onoda , Kahori Tsukura , Ken Takeda","doi":"10.1016/j.jpra.2025.01.014","DOIUrl":"10.1016/j.jpra.2025.01.014","url":null,"abstract":"<div><h3>Aim</h3><div>We developed a simple bipolar skin and subdermal hemostasis technique called the “Skin Subdermal Adhesion Technique” (SAT), which prevents postoperative complications and provides good cosmetic results.</div></div><div><h3>Patients and Methods</h3><div>We performed 40 ptosis surgeries in 20 patients using SAT. All patients underwent bilateral excision of the excess skin due to age-related upper eyelid skin laxity; patients with facial nerve palsy and those who underwent manipulation of the levator muscle were excluded. The maximum wound width of the defect after skin resection and diameter after SAT were measured. Additionally, the presence or absence of postoperative complications requiring additional surgeries or procedures was investigated.</div></div><div><h3>Results</h3><div>The mean (range) age was 76.0 (55–86) years. Among the bilateral resection widths, the diameter of the wider side was 11–20 mm (mean, 14.85±2.67 mm). In contrast, the defect width after SAT was 8–13 mm (mean, 9.75±1.84 mm). SAT reduced the maximum width by 34.3%. There were no cases of postoperative complications, such as wound hematoma formation or infection.</div></div><div><h3>Conclusion</h3><div>SAT is useful for treating upper eyelid skin defects because it does not require any special equipment, is quick to perform, reduces the risk of postoperative complications such as hematoma, and provides good cosmetic results.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"44 ","pages":"Pages 11-17"},"PeriodicalIF":1.5,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-23DOI: 10.1016/j.jpra.2025.01.010
M. Takemaru , H. Sakuma
Selective neurectomy of facial nerves is a treatment for post-facial paralysis synkinesis (PFS), which is a sequela of facial paralysis. Each branch of the facial nerve is stimulated during surgery, and nerve resection selection is determined based on the macroscopic findings. However, accurate assessment of the extent to which each nerve branch innervates a mimetic muscle is difficult. This may result in PFS recurrence or worsening of paralysis after surgery. Herein, we report a case of selective mid-facial neurectomy for PFS using an intraoperative nerve monitoring system.
A 60-year-old man presented with right-sided facial paralysis secondary to Hunt's syndrome. Two years after onset, the oral-ocular synkinesis worsened and the eyelids were closing completely during lip puckering. Therefore, we performed selective mid-facial neurectomy using an intraoperative nerve monitoring system.
During surgery, a skin incision was made from the temporal to the submandibular region, and the facial flap was elevated over the superficial musculoaponeurotic system (SMAS). Several nerve branches were identified by dissection of the area under the SMAS at the anterior border of the parotid gland. We stimulated each nerve branch while monitoring the orbicularis oculi, zygomaticus major, and orbicularis oris muscles. When certain nerve branches were stimulated, some of their mimetic muscles contracted. These branches were resected as they were thought to be responsible for PFS. The patient exhibited no obvious signs of PFS recurrence or worsening of paralysis at 3 months postoperatively. We believe that the intraoperative nerve monitoring system ensures the effectiveness and safety of selective mid-facial neurectomy.
{"title":"Selective mid-facial neurectomy using intraoperative nerve monitoring system for post-facial paralysis synkinesis","authors":"M. Takemaru , H. Sakuma","doi":"10.1016/j.jpra.2025.01.010","DOIUrl":"10.1016/j.jpra.2025.01.010","url":null,"abstract":"<div><div>Selective neurectomy of facial nerves is a treatment for post-facial paralysis synkinesis (PFS), which is a sequela of facial paralysis. Each branch of the facial nerve is stimulated during surgery, and nerve resection selection is determined based on the macroscopic findings. However, accurate assessment of the extent to which each nerve branch innervates a mimetic muscle is difficult. This may result in PFS recurrence or worsening of paralysis after surgery. Herein, we report a case of selective mid-facial neurectomy for PFS using an intraoperative nerve monitoring system.</div><div>A 60-year-old man presented with right-sided facial paralysis secondary to Hunt's syndrome. Two years after onset, the oral-ocular synkinesis worsened and the eyelids were closing completely during lip puckering. Therefore, we performed selective mid-facial neurectomy using an intraoperative nerve monitoring system.</div><div>During surgery, a skin incision was made from the temporal to the submandibular region, and the facial flap was elevated over the superficial musculoaponeurotic system (SMAS). Several nerve branches were identified by dissection of the area under the SMAS at the anterior border of the parotid gland. We stimulated each nerve branch while monitoring the orbicularis oculi, zygomaticus major, and orbicularis oris muscles. When certain nerve branches were stimulated, some of their mimetic muscles contracted. These branches were resected as they were thought to be responsible for PFS. The patient exhibited no obvious signs of PFS recurrence or worsening of paralysis at 3 months postoperatively. We believe that the intraoperative nerve monitoring system ensures the effectiveness and safety of selective mid-facial neurectomy.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 491-496"},"PeriodicalIF":1.5,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-15DOI: 10.1016/j.jpra.2025.01.006
Mohammad Khaled Hamolaila, Mazen Zenati, Asaad Shehada
Traditional scar treatments, such as laser therapy, chemical peels, and surgery, are expensive and require long recovery times. Polydioxanone (PDO) threads offer a minimally invasive and cost-effective solution that enhances collagen production and skin texture.
This study aimed to evaluate the effectiveness of PDO threads in the management of atrophic facial scars due to the lack of clinical research on this topic.
A prospective clinical study was conducted on 20 patients with facial atrophic scars caused by accidents or previous surgical procedures. The patient and observer scar assessment scale was used to evaluate the scars from the observer's and patient's perspectives at three-time points for each patient. The observer assessment included the following variables: vascularity, pigmentation, thickness, pliability, surface area, and homogeneity. The patient assessment included the following variables: pain, color, stiffness, thickness, appearance, and itching.
Statistically significant improvement was observed in atrophic facial scars treated using PDO threads in all observer variables (p<0.001). Significant improvement was recorded in the patient's color, stiffness, thickness, and appearance variables; however, itching sensation increased between T0 and T1 with no statistically significant differences in the pain variable.
Within the limits of this study, we conclude that PDO threads are known for ease of use, availability, and biocompatibility. They biodegrade naturally, reducing irritation risk. By stimulating collagen, PDO threads promote natural skin regeneration and thereby improve scars without using foreign materials. The treatment method is safe and minimally invasive, with short recovery times. Clinical studies showed significant improvements in atrophic facial scars with high patient satisfaction.
{"title":"Treating Facial Scars using Polydioxanone Threads","authors":"Mohammad Khaled Hamolaila, Mazen Zenati, Asaad Shehada","doi":"10.1016/j.jpra.2025.01.006","DOIUrl":"10.1016/j.jpra.2025.01.006","url":null,"abstract":"<div><div>Traditional scar treatments, such as laser therapy, chemical peels, and surgery, are expensive and require long recovery times. Polydioxanone (PDO) threads offer a minimally invasive and cost-effective solution that enhances collagen production and skin texture.</div><div>This study aimed to evaluate the effectiveness of PDO threads in the management of atrophic facial scars due to the lack of clinical research on this topic.</div><div>A prospective clinical study was conducted on 20 patients with facial atrophic scars caused by accidents or previous surgical procedures. The patient and observer scar assessment scale was used to evaluate the scars from the observer's and patient's perspectives at three-time points for each patient. The observer assessment included the following variables: vascularity, pigmentation, thickness, pliability, surface area, and homogeneity. The patient assessment included the following variables: pain, color, stiffness, thickness, appearance, and itching<strong>.</strong></div><div>Statistically significant improvement was observed in atrophic facial scars treated using PDO threads in all observer variables (p<0.001). Significant improvement was recorded in the patient's color, stiffness, thickness, and appearance variables; however, itching sensation increased between T0 and T1 with no statistically significant differences in the pain variable.</div><div>Within the limits of this study, we conclude that PDO threads are known for ease of use, availability, and biocompatibility. They biodegrade naturally, reducing irritation risk. By stimulating collagen, PDO threads promote natural skin regeneration and thereby improve scars without using foreign materials. The treatment method is safe and minimally invasive, with short recovery times. Clinical studies showed significant improvements in atrophic facial scars with high patient satisfaction.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 497-505"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-11DOI: 10.1016/j.jpra.2025.01.001
Albert Lamas Llopis , Sergi Barrantes , Laura Torrano Romero , Silvia de la Torre González , Luís Martínez-Sapiña , JA Palacín Porté , Anna López Ojeda
Extracorporeal Membrane Oxygenation (ECMO) placement in heart transplant patients can lead to the development of a groin lymphocele. Surgery is usually considered when conservative treatment fails. Indocyanine Green (ICG) lymphography enables the identification and ligation of damaged lymphatic vessels responsible for the lymphocele, while preserving intact lymphatic structures. In this paper, we present a case report highlighting the use of ICG lymphography-guided ligation of lymphatic leaks to treat a groin lymphocele following ECMO placement in a heart transplant patient.
{"title":"Indocyanine Green Lymphography-guided Ligation to Treat ECMO-related Groin Lymphocele","authors":"Albert Lamas Llopis , Sergi Barrantes , Laura Torrano Romero , Silvia de la Torre González , Luís Martínez-Sapiña , JA Palacín Porté , Anna López Ojeda","doi":"10.1016/j.jpra.2025.01.001","DOIUrl":"10.1016/j.jpra.2025.01.001","url":null,"abstract":"<div><div>Extracorporeal Membrane Oxygenation (ECMO) placement in heart transplant patients can lead to the development of a groin lymphocele. Surgery is usually considered when conservative treatment fails. Indocyanine Green (ICG) lymphography enables the identification and ligation of damaged lymphatic vessels responsible for the lymphocele, while preserving intact lymphatic structures. In this paper, we present a case report highlighting the use of ICG lymphography-guided ligation of lymphatic leaks to treat a groin lymphocele following ECMO placement in a heart transplant patient.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 470-474"},"PeriodicalIF":1.5,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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