Pub Date : 2024-02-29DOI: 10.20517/2347-9264.2023.110
Beatrice Go, Emily Deane, Oren Friedman
Empty nose syndrome (ENS) is an iatrogenic condition that results from traumatic injury, often overresection, of the turbinates during sinonasal surgery. The underlying etiology is not entirely understood but is thought to have multifactorial contributions including alterations in the native nasal airway anatomy, abnormal mucosal and neural healing, and decreased trigeminal sensitivity, among other possibilities and contributors. Patients typically present with an intense fixation on their sensations of nasal obstruction and congestion despite an anatomically patent airway on examination. Because many patients with ENS have been shown to have significant psychiatric comorbidities, multidisciplinary specialist care including psychiatry and pain services is essential. Diagnosis is often difficult due to the variability of presentation and severity of symptoms, but standard assessments exist including the empty nose syndrome 6-item questionnaire (ENS6Q) and cotton test. Patients can be initially managed with conservative measures through humidification, moisturization, and psychiatric testing/referral. Procedural approaches to improve the nasal airway include submucosal implantation of temporary, semi-permanent, and permanent materials. A realistic and empathetic approach to patient communication is necessary in order to help manage patients with ENS, and all plastic surgeons performing septorhinoplasty should be aware of the risk and treatment options of the disease.
{"title":"Empty nose syndrome","authors":"Beatrice Go, Emily Deane, Oren Friedman","doi":"10.20517/2347-9264.2023.110","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.110","url":null,"abstract":"Empty nose syndrome (ENS) is an iatrogenic condition that results from traumatic injury, often overresection, of the turbinates during sinonasal surgery. The underlying etiology is not entirely understood but is thought to have multifactorial contributions including alterations in the native nasal airway anatomy, abnormal mucosal and neural healing, and decreased trigeminal sensitivity, among other possibilities and contributors. Patients typically present with an intense fixation on their sensations of nasal obstruction and congestion despite an anatomically patent airway on examination. Because many patients with ENS have been shown to have significant psychiatric comorbidities, multidisciplinary specialist care including psychiatry and pain services is essential. Diagnosis is often difficult due to the variability of presentation and severity of symptoms, but standard assessments exist including the empty nose syndrome 6-item questionnaire (ENS6Q) and cotton test. Patients can be initially managed with conservative measures through humidification, moisturization, and psychiatric testing/referral. Procedural approaches to improve the nasal airway include submucosal implantation of temporary, semi-permanent, and permanent materials. A realistic and empathetic approach to patient communication is necessary in order to help manage patients with ENS, and all plastic surgeons performing septorhinoplasty should be aware of the risk and treatment options of the disease.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140410137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.20517/2347-9264.2023.82
Yasmeen Al-Hashimi, Benjamin Ferembach, Vincent Martinel, E. Hagert
The most common nerve compression in the upper extremity is that of carpal tunnel syndrome. Although generally recognized and treated, as much as a 20% failure rate is reported. Recent publications are indicating that one of the sources of persistent median nerve symptoms may be missed proximal median nerve entrapments, of which the lacertus fibrosus represents a principal cause of compression, and rarely other sites such as the flexor superficialis arch or pronator teres. Compression by the lacertus fibrosus is called lacertus syndrome, and as this is a clinically diagnosed entity, only rarely confirmed using electrodiagnostic or imaging studies, it is frequently overlooked. Clinicians regularly treating patients with carpal tunnel syndrome or patients with signs of median nerve neuropathy should be aware of the lacertus fibrosus as a possible compression site. In this review, we will define lacertus syndrome, describe its clinical manifestations and diagnosis, and demonstrate surgical techniques used to treat it.
{"title":"Painful nerve compression beyond the carpal tunnel: recognizing the lacertus syndrome","authors":"Yasmeen Al-Hashimi, Benjamin Ferembach, Vincent Martinel, E. Hagert","doi":"10.20517/2347-9264.2023.82","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.82","url":null,"abstract":"The most common nerve compression in the upper extremity is that of carpal tunnel syndrome. Although generally recognized and treated, as much as a 20% failure rate is reported. Recent publications are indicating that one of the sources of persistent median nerve symptoms may be missed proximal median nerve entrapments, of which the lacertus fibrosus represents a principal cause of compression, and rarely other sites such as the flexor superficialis arch or pronator teres. Compression by the lacertus fibrosus is called lacertus syndrome, and as this is a clinically diagnosed entity, only rarely confirmed using electrodiagnostic or imaging studies, it is frequently overlooked. Clinicians regularly treating patients with carpal tunnel syndrome or patients with signs of median nerve neuropathy should be aware of the lacertus fibrosus as a possible compression site. In this review, we will define lacertus syndrome, describe its clinical manifestations and diagnosis, and demonstrate surgical techniques used to treat it.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140438863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-21DOI: 10.20517/2347-9264.2023.57
Jason Lin, Ida K Fox
Cervical spinal cord injury is a life-altering event that profoundly affects an individual’s upper extremity function. Nerve transfer surgeries have been shown to restore more natural movement and fine motor control in this population. At present, there is no consensus on how to evaluate the efficacy of these restorative surgeries. The purpose of this work was to perform a comprehensive review of the existing literature and describe the outcome measures used. We hypothesized that the assessments will be heterogeneous across studies and will incompletely capture the effect of nerve transfers on upper extremity motion in cervical spinal cord injury. A search strategy was designed and a review of multiple databases (Embase.com, Ovid-Medline All, and Scopus) yielded 481 articles; 26 unique studies met inclusion criteria and underwent analysis. Both manual muscle strength testing and video content were presented in the majority of studies. Outcome assessments including myometry, functional outcomes measures (such as the grasp and release test), patient-reported outcomes (including generic, extremity, and disease-specific types), and custom de novo questionnaires were used variably across studies. Future work should focus on standardizing outcomes measures in the field and developing and incorporating kinematic analysis to quantify the intricate, coordinated, and precise movement attained after nerve transfer surgery in the setting of cervical spinal cord injury.
颈椎脊髓损伤是一种改变生命的疾病，会严重影响患者的上肢功能。神经转移手术已被证明能使这类人群恢复更自然的运动和精细运动控制能力。目前，对于如何评估这些恢复性手术的疗效还没有达成共识。这项工作的目的是对现有文献进行全面回顾，并描述所使用的结果测量方法。我们假设，不同研究的评估方法不尽相同，不能完全反映神经转移对颈脊髓损伤患者上肢运动的影响。我们设计了一种检索策略，并对多个数据库（Embase.com、Ovid-Medline All 和 Scopus）进行了检索，共检索到 481 篇文章；其中 26 项研究符合纳入标准并进行了分析。大多数研究都提供了手动肌力测试和视频内容。结果评估包括肌力测定、功能性结果测量（如抓握和释放测试）、患者报告结果（包括通用类型、四肢类型和疾病特异性类型）以及定制的新问卷，各研究的使用情况不尽相同。未来的工作重点应该是规范该领域的结果测量方法，并开发和纳入运动学分析，以量化颈脊髓损伤患者在神经转移手术后所获得的复杂、协调和精确的运动。
{"title":"Review of outcomes measures used to evaluate upper extremity surgical treatment of cervical spinal cord injury with recommendations for the future","authors":"Jason Lin, Ida K Fox","doi":"10.20517/2347-9264.2023.57","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.57","url":null,"abstract":"Cervical spinal cord injury is a life-altering event that profoundly affects an individual’s upper extremity function. Nerve transfer surgeries have been shown to restore more natural movement and fine motor control in this population. At present, there is no consensus on how to evaluate the efficacy of these restorative surgeries. The purpose of this work was to perform a comprehensive review of the existing literature and describe the outcome measures used. We hypothesized that the assessments will be heterogeneous across studies and will incompletely capture the effect of nerve transfers on upper extremity motion in cervical spinal cord injury. A search strategy was designed and a review of multiple databases (Embase.com, Ovid-Medline All, and Scopus) yielded 481 articles; 26 unique studies met inclusion criteria and underwent analysis. Both manual muscle strength testing and video content were presented in the majority of studies. Outcome assessments including myometry, functional outcomes measures (such as the grasp and release test), patient-reported outcomes (including generic, extremity, and disease-specific types), and custom de novo questionnaires were used variably across studies. Future work should focus on standardizing outcomes measures in the field and developing and incorporating kinematic analysis to quantify the intricate, coordinated, and precise movement attained after nerve transfer surgery in the setting of cervical spinal cord injury.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"13 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140442045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.20517/2347-9264.2023.94
Karen Brown, Makayla Mccoskey, Tanuj Nakra
Autologous fat grafting is a commonly performed procedure for facial volume augmentation and rejuvenation. While overall complication rates in the literature are low, adverse events related to fat grafting can range from minor to systemic and severe. It is crucial that the surgeon be aware of these potential complications, counsel patients appropriately, and take the necessary steps to mitigate these risks. Local graft site complications include contour irregularity, over- or under-volumization, prolonged edema and ecchymosis, fat necrosis, granuloma formation, and infection. Similar complications can also be seen at the donor sites, including contour irregularity, prolonged induration or erythema, infection, and skin pigmentation changes. Finally, the most severe complications, resulting from fat embolism due to intravascular injection, can result in vision loss or stroke. In this review, risk factors for adverse events, surgical techniques to mitigate risk, and potential treatment options for complications of autologous fat grafting are reviewed.
{"title":"Complications of facial autologous fat grafting","authors":"Karen Brown, Makayla Mccoskey, Tanuj Nakra","doi":"10.20517/2347-9264.2023.94","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.94","url":null,"abstract":"Autologous fat grafting is a commonly performed procedure for facial volume augmentation and rejuvenation. While overall complication rates in the literature are low, adverse events related to fat grafting can range from minor to systemic and severe. It is crucial that the surgeon be aware of these potential complications, counsel patients appropriately, and take the necessary steps to mitigate these risks. Local graft site complications include contour irregularity, over- or under-volumization, prolonged edema and ecchymosis, fat necrosis, granuloma formation, and infection. Similar complications can also be seen at the donor sites, including contour irregularity, prolonged induration or erythema, infection, and skin pigmentation changes. Finally, the most severe complications, resulting from fat embolism due to intravascular injection, can result in vision loss or stroke. In this review, risk factors for adverse events, surgical techniques to mitigate risk, and potential treatment options for complications of autologous fat grafting are reviewed.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139897056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.20517/2347-9264.2023.94
Karen Brown, Makayla Mccoskey, Tanuj Nakra
Autologous fat grafting is a commonly performed procedure for facial volume augmentation and rejuvenation. While overall complication rates in the literature are low, adverse events related to fat grafting can range from minor to systemic and severe. It is crucial that the surgeon be aware of these potential complications, counsel patients appropriately, and take the necessary steps to mitigate these risks. Local graft site complications include contour irregularity, over- or under-volumization, prolonged edema and ecchymosis, fat necrosis, granuloma formation, and infection. Similar complications can also be seen at the donor sites, including contour irregularity, prolonged induration or erythema, infection, and skin pigmentation changes. Finally, the most severe complications, resulting from fat embolism due to intravascular injection, can result in vision loss or stroke. In this review, risk factors for adverse events, surgical techniques to mitigate risk, and potential treatment options for complications of autologous fat grafting are reviewed.
{"title":"Complications of facial autologous fat grafting","authors":"Karen Brown, Makayla Mccoskey, Tanuj Nakra","doi":"10.20517/2347-9264.2023.94","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.94","url":null,"abstract":"Autologous fat grafting is a commonly performed procedure for facial volume augmentation and rejuvenation. While overall complication rates in the literature are low, adverse events related to fat grafting can range from minor to systemic and severe. It is crucial that the surgeon be aware of these potential complications, counsel patients appropriately, and take the necessary steps to mitigate these risks. Local graft site complications include contour irregularity, over- or under-volumization, prolonged edema and ecchymosis, fat necrosis, granuloma formation, and infection. Similar complications can also be seen at the donor sites, including contour irregularity, prolonged induration or erythema, infection, and skin pigmentation changes. Finally, the most severe complications, resulting from fat embolism due to intravascular injection, can result in vision loss or stroke. In this review, risk factors for adverse events, surgical techniques to mitigate risk, and potential treatment options for complications of autologous fat grafting are reviewed.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"100 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139893641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-31DOI: 10.20517/2347-9264.2023.79
Kimberly Chan, Mohamad Saltagi, Karen Y. Choi
Management of clinically negative necks (cN0) in oral cavity (OCSCC) and oropharyngeal (OPSCC) squamous cell carcinoma (SCC) has evolved over time. Historically, the clinically negative neck has been managed with elective neck dissection (END) or observation, but more recently sentinel lymph node biopsy (SLNB) has emerged as a technique to detect occult metastases. In this review, we will discuss the role of SLNB in early-stage OCSCC and in the management of OPSCC.
{"title":"The emerging role of sentinel lymph node biopsy in oral cavity and oropharyngeal carcinomas","authors":"Kimberly Chan, Mohamad Saltagi, Karen Y. Choi","doi":"10.20517/2347-9264.2023.79","DOIUrl":"https://doi.org/10.20517/2347-9264.2023.79","url":null,"abstract":"Management of clinically negative necks (cN0) in oral cavity (OCSCC) and oropharyngeal (OPSCC) squamous cell carcinoma (SCC) has evolved over time. Historically, the clinically negative neck has been managed with elective neck dissection (END) or observation, but more recently sentinel lymph node biopsy (SLNB) has emerged as a technique to detect occult metastases. In this review, we will discuss the role of SLNB in early-stage OCSCC and in the management of OPSCC.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"139 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140477853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-17DOI: 10.20517/2347-9264.2019.15
S. Patel, A. Mericli, S. Kapur, Margaret S Roubaud, Charles E. Butler
Large abdominal cutaneous defects may occur in association with complex ventral hernias, trauma, tumor resection, necrotizing infections or septic evisceration. Soft tissue reconstruction of the abdominal wall is performed when there is insufficient adipocutaneous tissue to permit standard, primary closure. A number of reconstructive techniques are available, the choice of which is based on a number of factors, including the size and location of the defect, etiology, and timing of closure. In general, local fasciocutaneous advancement flaps and adjacent tissue rearrangement are the workhorse techniques, followed by regional myocutaneous flaps and free tissue transfers for the most complex and extensive of defects. Herein, we describe our approach to abdominal soft tissue reconstruction, indications, technical nuances, and management of complications.
{"title":"Flap reconstruction of the abdominal wall","authors":"S. Patel, A. Mericli, S. Kapur, Margaret S Roubaud, Charles E. Butler","doi":"10.20517/2347-9264.2019.15","DOIUrl":"https://doi.org/10.20517/2347-9264.2019.15","url":null,"abstract":"Large abdominal cutaneous defects may occur in association with complex ventral hernias, trauma, tumor resection, necrotizing infections or septic evisceration. Soft tissue reconstruction of the abdominal wall is performed when there is insufficient adipocutaneous tissue to permit standard, primary closure. A number of reconstructive techniques are available, the choice of which is based on a number of factors, including the size and location of the defect, etiology, and timing of closure. In general, local fasciocutaneous advancement flaps and adjacent tissue rearrangement are the workhorse techniques, followed by regional myocutaneous flaps and free tissue transfers for the most complex and extensive of defects. Herein, we describe our approach to abdominal soft tissue reconstruction, indications, technical nuances, and management of complications.","PeriodicalId":517140,"journal":{"name":"Plastic and Aesthetic Research","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141211336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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