Abstract:
:The purpose of this two-part study was to evaluate the safety of surgical management of speech production disorders in patients with velocardiofacial syndrome without preoperative cervical vascular imaging studies. Anomalous internal carotid arteries have been shown to be a frequent feature of velocardiofacial syndrome. These vessels pose a potential risk for hemorrhage during velopharyngeal narrowing procedures. Magnetic resonance angiography, and other forms of cervical vascular imaging studies such as computerized tomography, have been advocated as aids to surgery by defining the preoperative vascular anatomy. However, it remains unclear whether these studies alter either the conduct or outcome of operations on the velopharynx. In the first part of this study, we reviewed the charts and videonasendoscopic evaluations of 39 consecutive patients with confirmed or suspected velocardiofacial syndrome who underwent sphincter pharyngoplasty or pharyngeal flap from 1978 to 1996. The charts were reviewed to determine (1) the frequency of identification of abnormal pharyngeal pulsations; (2) whether such pulsations affected the conduct of the operative procedure; and (3) whether the presence of pulsations affected surgical morbidity and/or surgical outcome. None of the patients underwent any type of cervical vascular imaging study. In the second part of this study, we surveyed plastic surgeons with numerous years of experience participating on cleft-craniofacial teams, to ascertain practice patterns relating to the management of patients with velocardiofacial syndrome. The questions related specifically to the surgeons' behavior in relation to angiography and their awareness of any cases of surgical morbidity related to the cervical vascular system in patients with velocardiofacial syndrome. We were interested in discerning both how commonly this situation arises clinically and the distribution of the various types of operative procedures in common use. Of our 39 patients, 10 patients (26 percent) had detectable pulsations on preoperative nasendoscopy. Of these, five patients underwent sphincter pharyngoplasty and five underwent pharyngeal flap procedures. Preoperative instrumental and intraoperative clinical assessment of pulsatile vessels allowed velopharyngeal reconstruction in all patients without surgical morbidity. Results of the questionnaire indicated that most cleft surgeons do not routinely order cervical vascular imaging studies for all of their patients with velocardiofacial syndrome. About half of the respondents indicated that their operative approach was influenced by information obtained from angiographic studies. None of the surgeons queried were aware of any cases of surgical morbidity related to the cervical vascular system in patients with velocardiofacial syndrome. Nearly 50 percent of surgeons use pharyngeal flap procedures most frequently, whereas 22 percent of surgeons use sphincter pharyngoplasty most frequently. Results of this study support the safety of sphincter pharyngoplasty or pharyngeal flap procedures in patients with velocardiofacial syndrome without preparatory angiography. These procedures can be performed safely, even in patients having aberrant velopharyngeal pulsations. Given the market cost of magnetic resonance angiography ($1600), one must question the cost-efficacy of magnetic resonance angiography for routine use in the velocardiofacial syndrome population.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Witt PD,Miller DC,Marsh JL,Muntz HR,Grames LMsubject
Has Abstractpub_date
1998-04-01 00:00:00pages
1184-95; discussion 1196-9issue
5eissn
0032-1052issn
1529-4242journal_volume
101pub_type
杂志文章,多中心研究abstract:BACKGROUND:The psychosocial benefits of postmastectomy breast reconstruction are well established; however, health care barriers persist. The authors evaluated statewide patient population to further identify obstacles to reconstruction. METHODS:A linked data set combining the North Carolina Central Cancer Registry wi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002343
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the efficacy of postoperative intense pulsed light therapy on patients who undergo bilateral eyelid surgery. METHODS:Patients presenting over a 3-month period for bilateral eyelid surgery were asked to participate in an institutional review board-approved study. Int...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/PRS.0000000000002086
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:In deep inferior epigastric perforator (DIEP) flap breast reconstructions, a free tissue flap from the abdomen is shaped into a breast and transferred to the thorax. Survival of this free flap relies on minuscule blood vessels, so-called perforators, providing blood supply to this newly molded breast. Preope...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/PRS.0000000000005614
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The objective of this study was to report outcomes after initiation of an algorithmic approach (Bethesda protocol) using intracranial free flaps, cranial bone autografts, and dermal/fat grafts to treat warfare-related cranial frontofacial defects after war-related decompressive craniectomy. METHODS:A retros...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318267d5cb
更新日期:2012-11-01 00:00:00
abstract::In a blind, randomized study, two groups, each of seven rabbits, were treated with either a very low dose of human melanoma cell line-derived tissue-type plasminogen activator (t-PA) or isotonic saline. t-PA (0.067 mg/kg of body weight) was administered intraaortically, 20 percent being given as a 30-second "bolus" in...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1992-08-01 00:00:00
abstract::Breast reconstructions performed with latissimus dorsi and transverse rectus abdominis myocutaneous (TRAM) flaps in 82 patients with a history of previous chest-wall irradiation were compared with similar reconstructions in 202 nonirradiated patients to determine whether prior irradiation was associated with more freq...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:The compromised airway in Robin sequence demands prompt operative intervention. Tongue-lip adhesion is one alternative; however, the outcome of this technique is variable. The purpose of this study was to identify variables that preoperatively predict the success of adhesion in Robin sequence patients with l...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318217420d
更新日期:2011-07-01 00:00:00
abstract::An experimental animal study was undertaken to evaluate the potential use of HTR polymer as a craniomaxillofacial reconstructive material. Its properties of marked hydrophilicity, a negative surface charge, and extensive porosity combined with a calcium graft coating suggested favorable osteoconductive properties. Fou...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199012000-00006
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Surgical treatment of injuries with loss of skin tissue has improved significantly with the advent of regenerative medicine and tissue bioengineering, and the use of stem cells and dermal substitutes. The success of tissue regeneration depends on optimal local vascularization and the successful integration o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182547e04
更新日期:2012-07-01 00:00:00
abstract::Reconstruction of infected median sternotomy wounds using muscle and omental flaps has been shown to result in significantly reduced morbidity, mortality, and length of hospital stay. Despite these benefits, very little is known about the potential long-term sequelae of such procedures. The purpose of this study was t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract::The purpose of this Special Topic article is to present the current state of scientific evidence related to the safety of silicone breast implants. There is presently overwhelming evidence to support the safety of silicone breast implants. Ultimately, the decision to obtain, keep, or remove breast implants is the choi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000005710
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:The occipitocervicopectoral flap has a local skin pedicle in the occipital region, with the distal portion of the flap in the pectoral region. One disadvantage of the occipitocervicopectoral flap is its limited flap length. To overcome this disadvantage, a perforator supercharging technique was applied to en...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318244230b
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:The increasing use of autologous fat grafting in breast cancer patients has raised concerns regarding its oncologic safety. This study evaluated patient outcomes and tumor recurrence following mastectomy reconstruction and autologous fat grafting. METHODS:Retrospective chart review identified patients who u...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003576
更新日期:2017-09-01 00:00:00
abstract::After nearly any form of cardiac surgery, an acute febrile illness characterized by leukocytosis, pericarditis with pericardial effusion, and pleural effusion may occur. In some instances, this postpericardiotomy syndrome may suggest the presence of mediastinal infection. Treatment of postpericardiotomy syndrome is co...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
abstract::A shallow buccal sulcus deformity following bilateral cleft lip repair is not rare. A variety of techniques are described for the secondary reconstruction of a deficient sulcus. Most of these are associated with a variable amount of contraction with subsequent obliteration of the sulcus. In this article, an inverted U...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200112000-00004
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Much of the literature on the epidemiology of cleft lip with or without cleft palate is more than three decades old. The question arose as to whether there has been any recent change or trend in its rate of occurrence. METHODS:The number of live births with cleft lip or other congenital anomalies was solici...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182402dd1
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to compare clinical outcomes and 1-year postsurgical stability with three different techniques of Le Fort III midface advancement. METHODS:The records of 212 syndromic craniosynostosis patients were reviewed from the period 1973 to 2006. A total of 60 patients satisfied the inc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181e6051e
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The misuse and abuse of opioids, including overprescription, has led to the current opioid epidemic and national crisis. There is a national effort to eliminate the unnecessary prescription of opioids for analgesia. METHODS:Seventy patients were randomized to receive postoperative analgesia with either 5 mg...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007427
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The combination of endoscope-assisted suturectomy and postoperative helmet therapy has been advocated to treat unilateral coronal synostosis. However, surgical outcomes can vary. One possible explanation for this inconsistency is early closure of the craniectomy gap. The authors examined short-term postopera...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000285
更新日期:2014-07-01 00:00:00
abstract::Defects of the heel and sole represent difficult reconstructive problems in terms of tissue availability and postoperative morbidity. Although local flaps offer the optimal type of coverage, their application has been restricted to defects of limited size. A study of the plantar skin and fascia, as well as its neurova...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198008000-00014
更新日期:1980-08-01 00:00:00
abstract::Design and preoperative planning of microsurgical flaps are fundamental steps for successful surgery. Currently, computed tomographic angiography is considered the gold standard, and new technologies such as thermography could complement its usefulness. The aim of this study was to determine the concordance between th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004126
更新日期:2018-03-01 00:00:00
abstract::In spite of adequate preoperative evaluation, lagophthalmos may appear during a brow lift procedure if the patient has had a prior upper lid blepharoplasty. Relief of this condition may be obtained by incising the upper lid scar and spreading the wound. Subsequent granulation results in an acceptable scar. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199511000-00037
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:In the spring of 2000, the U.S. Food and Drug Administration issued a ban on the use of Betadine (povidone-iodine; Purdue Frederick, Stamford, Conn.) in association with saline breast implants, because data seemed to indicate a higher rate of implant deflation in association with Betadine. Betadine has been ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000251088.51675.a8
更新日期:2007-01-01 00:00:00
abstract::Silicone gel leakage problems are central to the furor over the complications alleged to be caused by breast implants. Because clinical examination may not reveal confirmatory signs of gel bleed or rupture, radiologists are often requested by plastic surgeons to evaluate the integrity of the implant's envelope. The fi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/00006534-199809040-00062
更新日期:1998-09-01 00:00:00
abstract::I didactically compared the breast as a glandular cone with an envelope of skin and subcutaneous tissue. The aesthetic alterations of the breast are classified in four groups related to form, to volume, to grams, and to ptosis in centimeters. An imaginary plane that passes by the mammary sulcus (plane A) will determin...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199005000-00013
更新日期:1990-05-01 00:00:00
abstract::An inferiorly based rectus abdominis musculocutaneous flap is transferred to the sacrogluteal region through a transiliac approach. This technique is a simple and safe alternative to obtain a short pathway from the anterior abdomen to the sacral area. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199212000-00028
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Although the increasing trend is to rebuild facial soft-tissue volume with autologous fat transfer, there is no agreement concerning the best way of processing the harvested fat before reinjecting it. Among all the reported fat graft processing techniques, in the present study, the authors compared the clini...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3182131d5d
更新日期:2011-06-01 00:00:00
abstract::Primary mucinous carcinoma of the skin is a slow-growing tumor with a high recurrence rate. To improve the recognition of the clinical entity, two cases of this tumor were reported and were investigated histopathologically and histochemically. Both patients showed no evidence of metastatic mucinous adenocarcinoma int ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199704000-00040
更新日期:1997-04-01 00:00:00
abstract::A simple technique for closure of a palatal fistula using a conchal cartilage graft as a substitute for nasal lining flaps is reported. This graft simplifies the repair of the palatal fistula and protects the suture line of the oral covering flaps from recurrence. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199108000-00029
更新日期:1991-08-01 00:00:00
abstract::A method of covering lower-extremity wounds using a free fascial scalp flap has been described. The flap provides thin, stable wound coverage, with minimal bulk and an inconspicuous donor site. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198008000-00004
更新日期:1980-08-01 00:00:00