0000000001132720
AUTHOR
Michele Cillino
Clinical neurophysiology and imaging of nerve injuries: preoperative diagnostic work-up and postoperative monitoring
Peripheral nerve injuries are a heterogeneous group of lesions that may occurs secondary to various causes. Several different classifications have been used to describe the pathophysiological mechanisms leading to the clinical deficit, from simple and reversible compression-induced demyelination, to complete transection of nerve axons. Neurophysiological data localize, quantify, and qualify (demyelination vs . axonal loss) the clinical and subclinical deficits. High-resolution ultrasound can demonstrate the morphological extent of nerve damage, fascicular echotexture (epineurium vs . perineurium, focal alteration of the cross-section of the nerve, any neuromas, etc. ), and the surrounding t…
ALGORITHM OF PARTIAL BREAST RECONSTRUCTION WITH PEDICLED PERFORATOR FLAPS
INTRODUCTION: The authors present an algorithm of partial breast reconstruction following quadrantectomy that allows to restore the breast volume defect with the use of pedicled perforator flaps. MATERIAL AND METHODS: Between March 2009 and May 2010, at the Plastic and Reconstructive Institute of University of Palermo, pedicled perforator flaps were used to integrate volume and/or breast skin in 12 patients after benign and malignant breast tumors. The flaps used were based on perforators of the thoraco-dorsal artery (TDAP) and of the intercostal arteries (ICAP). TDAP flaps were used to reconstruct defects in any breast quadrant, while ICAP perforator were used to reconstruct lateral and ce…
The chimeric ALT-vastus lateralis free flap in reconstruction of advanced BRONJ of the maxilla.
Introduction Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a dangerous complication of bisphosphonates, a class of pharmaceutical agents used in numerous bone disor- ders. No gold standard therapy exists, but recent literature suggests that, in advanced stages, the best results are achieved with aggressive debridement. In this paper, we report our experience of treatment of stage 3 BRONJ of the maxilla with extensive surgical debridement and reconstruction with a chimeric ALT-Vastus lateralis flap. Methods Five selected patients with stage 3 BRONJ underwent partial maxillectomy with dis- ease-free margins followed by immediate reconstruction with a chimeric ALT-Vastus lateralis…
An algorithm to improve outcomes of radial forearm flap donor site
Background: Due to the high rate of donor site complications the Radial Forearm Flap (RFF) has lost ground in favor of the Antero-lateral tight flap (ALT) and other flaps. We have designed a reconstruction algorithm for reconstruction of its donor site. The goal of this study was to retrospectively evaluate the impact of this algorithm on RFF donor site compli- cation rates. Methods: The authors analyzed retrospectively 31 patients who underwent free radial fore- arm flap reconstruction between November 2009 and May 2013. Donor site complications were compared with data from patients treated before introdutction of the algorithm. Within the group were compared patients in which the flap was…
Irreversible changes occurring in long-term denervated Schwann cells affect delayed nerve repair.
OBJECTIVEMultiple factors may affect functional recovery after peripheral nerve injury, among them the lesion site and the interval between the injury and the surgical repair. When the nerve segment distal to the lesion site undergoes chronic degeneration, the ensuing regeneration (when allowed) is often poor. The aims of the current study were as follows: 1) to examine the expression changes of the neuregulin 1/ErbB system during long-term nerve degeneration; and 2) to investigate whether a chronically denervated distal nerve stump can sustain nerve regeneration of freshly axotomized axons.METHODSThis study used a rat surgical model of delayed nerve repair consisting of a cross suture betw…
Ultrasonography and Nerve Conduction Study in patients with carpal tunnel syndrome, comparison between the two techniques before and after median nerve decompression surgery: observational study
Abstract Purpose: Traditional evaluation of suspected carpal tunnel syndrome (CTS) involves a thorough history, physical examination, and nerve conduction velocity studies (NCS). The aim of the study is to evaluate whether ultrasound (US) is a valid alternative to the emg as a routine pre-operative examination, to evaluate patients with STC, comparing some us values with NCS findings pre and postopertively Methods: Only patients with symptoms, clinical examination, and NCS findings consistent with CTS were included in the study, according to the inclusion criteria. Four ultrasonographic variables were considered in treated patients: 1) CSPA (cross sectional pisiform area); 2) S-P dt: the la…