Oncological and aesthetic outcome following surgical management of orbito-palpebral skin cancers: A retrospective study of 132 patients

BackgroundThe incidence of facial skin cancers continues to rise, with major studies on their impacts still lacking in the literature. This study reports on the oncological and aesthetic results following surgical management of an orbito-palpebral skin cancer.MethodsThis retrospective, monocentric study included patients treated for a non-melanoma skin cancer of the eyelid and orbit. Risk factors, location, histological type, invaded or insufficient margins, healing time, surgical management by excision and direct closure, skin graft or local flaps, self-evaluated aesthetics, and quality of life results were all compared.ResultsThe study included 132 patients operated for basal cell carcinoma (71.9%), squamous cell carcinoma (22.9%), or for another type (5.2%) between November 2011 and January 2017. Average tumor size was 9.6 ± 6.3 mm. Surgical management resulted in excision and open healing (9.1%), excision and direct closure (3.9%), skin graft (31.1%), local flap (21.9%), or another type of reconstruction (3.0%). Significant links between invaded or insufficient margins and basal cell type (OR = 3.37, p = 0.014), tumor size over 7 mm (OR = 2.7, p = 0.011), double location (OR = 8.44, p = 0.04), flap-based reconstruction (OR = 0.290, p = 0.02), and female gender (OR = 0.418, p = 0.034) were reported throughout our multivariate analysis.ConclusionsThis study brings out consequential information on factors linked with invaded or insufficient excision margins. Larger cohorts should evaluate the aesthetic outcomes in such a population.     

不同方式修复末节指皮肤缺损疗效分析

目的探讨不同方式修复末节指皮肤缺损的临床疗效。方法对171例226指末节皮肤缺损进行修复:应用创必复联合海肤康护创指套修复53指,V-Y皮瓣修复43指,邻指皮瓣修复22指,指动脉逆行岛状皮瓣修复30指,指背筋膜蒂逆行皮瓣修复57指,拇背皮神经营养血管皮瓣修复21指。结果 171例均获随访,时间1.5个月~2年。226指末节皮肤缺损全部愈合(其中3例皮瓣受区感染经换药等处理后治愈)。创必复海肤康指套治疗者指腹饱满,外观满意;皮瓣修复者质地和颜色与受区相近,感觉恢复良好,功能满意。结论末节指皮肤缺损目前有很多修复方式供选择,临床上要根据受伤末节指具体情况及患者要求灵活选用合适的、操作简单的修复方法,最大限度地恢复手指功能。     

Advance in Functional Restoration of Injured Nerve with Low Level Laser and its Utilization in the Dental and Maxillofacial Region

The inferior alveolar nerve and facial nerve are the two most important nerves in the dental and maxillofacial region. The injury to them is one of the major postoperative complications after alveolar surgery and orthognathic surgery. However, recovering the nerve function after injury takes a long time and the recovery effect tends to be unsatisfactory. In recent years, an intensively investigated technique, low level laser which has been applying in assisting the recovery of nerve function, has been gradually proved to be effective in clinically treating postoperative nerve injury. In this article we review in terms of the mechanisms involved in low level laser-assisted functional restoration of nerve injury and its clinical application in the recovery of nerve function in the dental and maxillofacial area as well.     

钛瓷瓷裂的临床研究和原因分析

目的：分析钛-瓷修复体失败的原因。方法：对38例瓷裂的钛-瓷修复体进行分析：①肉眼观察烤瓷崩瓷部铸件的表面颜色并用便携式厚度测试仪测量其厚度，与未发生瓷裂的正常镰铬合金烤瓷比较；②观察烤瓷崩瓷的部位；③X-ray检测铸件内部气孔。结果：本组崩瓷的钛-瓷修复体，其断层或有气泡，或金属表面氧化层明显增厚（P〈0．05）。而且，所有发生崩瓷的部位均在受力点或因技工本身操作不当引起。结论：钛-瓷修复体失败的原因与加工过程中工艺、瓷的受力点以及与钛元素化学性能有关。     

Aesthetic aspects in reconstructive microsurgery

The reconstruction of a part of the body that has lost or inhibited function has been the most important aspect of reconstructive surgery in the past. Because of the existence of better techniques and the patient's wish for social reintegration, the plastic surgeon today is forced to consider the aesthetic results of his work more than in the past. Sometimes microsurgical procedures in reconstructive surgery are the only chance for the patient to be healed or palliated. Experience with more than 350 free tissue transfers gave us the opportunity to estimate the value of a donor flap with respect to the requirements of the receiving site. To satisfy the high aesthetic demands in these cases, it was necessary for the right place and shape the flap to fit as closely as possible, even if further corrections were necessary to achieve a satisfactory result. The transfer of latissimus dorsi and radial forearm flaps to the face and lower leg is discussed in cases of tumorus diseases and severe injuries of young and old patients.Presented to the IXth Congress of the International Society of Aesthetic Plastic Surgery, New York, October 13, 1987     

Surgery for ventricular tachycardia in patients undergoing surgical ventricular restoration: The Karolinska approach

This article presents a review on the efficacy of surgical ventricular restoration and direct surgery for ventricular tachycardia in patients with left ventricular aneurysm or dilated ischemic cardiomyopathy. The procedure includes a non-electrophysiologically guided subtotal endocardiectomy and cryoablation in addition to endoventricular patch plasty of the left ventricle. Coronary artery bypass surgery and mitral valve repair are performed concomitantly as needed. In our experience, this procedure yielded a 90% success rate in terms of freedom from spontaneous ventricular tachycardia, with an early mortality rate of 3.8%. A practical guide to the pre- and postoperative management of these patients is provided. Electronic supplementary material The online version of this article (doi: ) contains supplementary material, which is available to authorized users.