Long-term complications of microtia reconstruction: A systematic review

xlomafota13 shared this article with you from Inoreader Long-term complications of microtia reconstruction: A systematic review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Aug 17:S1748-6815(21)00376-4. doi: 10.1016/j.bjps.2021.08.001. Online ahead of print. ABSTRACT BACKGROUND: Microtia is a rare disorder characterized by malformation or even complete absence of the auricle. Reconstruction is often performed using autologous costal cartilage (ACC) or porous polyethylene implants (PPE). However, the long-term outcomes of both methods are unclear. OBJECTIVE: This systematic review aimed to analyze long-term complications and suggest minimal reporting criteria for future original data studies. METHODS: A systematic literature search was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials from inception through October 14, 2020. Articles on auricular reconstruction in patients with microtia using ACC or PPE were included provided that the follow-up period was at least one year. This publication focused on long-term complications reported in patients with a postoperative follow-up period of at least one year. RESULTS: Twenty-nine publications reported on complications during long-term follow-up. Overall long-term complication rates were not reported. The incidence of individual complications during long-term follow-up was less than 10% after ACC reconstruction and less than 15% in PPE reconstruction. Framework resorption and wire exposure were reported even after an extended follow-up of more than five years after ACC reconstruction, while reports on the extended long-term results of PPE reconstruction are limited. Data synthesis was limited due to heterogeneity and poor study quality. CONCLUSIONS: Future studies should report on long-term complications including framework exposure or extrusion, graft loss, framework resorption, wire exposure and scalp and auricular scar complications. We recommend a surgical follow-up of at least five years. PMID:34481742 | DOI:10.1016/j.bjps.2021.08.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

3D-printed template and optical needle navigation in CT-guided iodine-125 permanent seed implantation

xlomafota13 shared this article with you from Inoreader 3D-printed template and optical needle navigation in CT-guided iodine-125 permanent seed implantation Via radioactive iodine J Contemp Brachytherapy. 2021 Aug;13(4):410-418. doi: 10.5114/jcb.2021.108595. Epub 2021 Aug 24. ABSTRACT PURPOSE: To preliminarily verify the accuracy of navigation-assisted seed implantation by comparing pre-operative and actual differences in puncture characteristics and dosimetry in computed tomography (CT)-guided, navigation-assisted radioactive iodine-125 seed implantation, using 3D-printed templates for malignant tumors' treatment. MATERIAL AND METHODS: A total of 27 t umor patients, who were treated with seed implantation under combination guidance in our hospital between December 2019 and December 2020 were enrolled in this study. Navigation needles (n = 1-3) were placed in each patient to obtain pre-operative and intra-operative puncture information, such as angle, depth, insertion point, and tip position. Moreover, dosimetry parameters in pre-operative and post-operative plans, including D90, V100, V150, V200, minimum peripheral dose (MPD), conformal index, external index, and homogeneity index of target area were investigated. RESULTS: Mean errors of the angle, depth, insertion point, and tip position were 0.5 ±0.5°, 4.0 ±2.0 mm, 1.7 ±1 mm, and 3.1 ±1.8 mm, respectively. There were no significant differences between intra-operative and pre-operative angles (p = 0.271), but there was a significant difference in the depth (p = 0.002). Errors of the angle, depth, and ins ertion point were larger for the pelvic/retroperitoneal area than for the head and neck/chest wall (p < 0.05). With the exception of MPD, there was no significant difference in dosimetry indices between post-operative and preoperative plans (p > 0.05). CONCLUSIONS: Seed implantation under combination guidance showed good accuracy, and the actual intra-operative puncture information and post-operative doses were in agreement with those in the pre-operative plan, thereby demonstrating promising prospects for further development. PMID:34484355 | PMC:PMC8407253 | DOI:10.5114/jcb.2021.108595 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear implantation under local anesthesia in 117 cases: patients' subjective experience and outcomes

xlomafota13 shared this article with you from Inoreader Cochlear implantation under local anesthesia in 117 cases: patients' subjective experience and outcomes Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 6. doi: 10.1007/s00405-021-07061-4. Online ahead of print. ABSTRACT PURPOSE: To report the outcomes and the patients' subjective experience of cochlear implantation (CI) performed under local anesthesia (LA). To describe a new form of intraoperative cochlear monitoring based on the patients subjective sound perception during CI. METHODS: In this retrospective case-cohort study, 117 patients underwent CI under LA with (n = 58) or without conscious sedation (n = 59). Included were primarily elderly patients with elevated risks for general anesthesia and recently patients with residual hearing eligible for electro-acoustic stimulation (EAS) (n = 27), in whom hearing could be monitored during the electrode insertion. A 500 Hz test tone was presented and the patient reported of subjective changes in loudness, leading to a modification of the insertion. A questionnaire was sent to all patients in whi ch they assessed their subjective experience. RESULTS: All patients were successfully operated under LA without the need to intraoperatively convert to general anesthesia. 90% of the patients reported that the surgery was a positive experience. The vast majority, 90% of patients were satisfied with the overall treatment and with intraoperative pain management and 84% of the patients would opt for local anesthesia again. Cochlear monitoring by the patients' subjective sound perception enabled for atraumatic insertions as all EAS patients could hear the test tone up to the end of the surgery. CONCLUSIONS: CI under LA was well tolerated and recommended by the vast majority of patients. In addition, it offers the possibility to monitor the patients' hearing during the electrode insertion, which may help to prevent insertion trauma. PMID:34487218 | DOI:10.1007/s00405-021-07061-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.