Plastic and reconstructive surgery最新文献

{"title":"\"Over 10 years follow-up experience after inverted T superior pedicle breast reduction with modified Ribeiro flap\".","authors":"Barbara Cagli, Andrea Aniello Cimmino, Iside Vignapiano, Daniela Porso, Francesco Sofo, Carlo Mirra, Luca Savani, Annalisa Cogliandro, Andrea Tarantino, Paolo Persichetti","doi":"10.1097/PRS.0000000000012108","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012108","url":null,"abstract":"<p><strong>Background: </strong>Several techniques have been developed to address cases of macromastia. The primary objective remains achieving optimal aesthetic outcomes while reducing breast volume, but concerns persist regarding the stability of results over time. In particular, as far as the superior pedicle T-inverted breast reduction with an inferiorly based dermal flap is concerned, long-term reported results stop at five years follow-up. This work investigates the outcome of this over 10 years follow-up, considering intrinsic and extrinsic factors that may contribute to ptosis recurrence.</p><p><strong>Methods: </strong>A total of 70 patients were included and examined in a long-term consultation, more than 10 years post-operation. Physical measures, including standard breast distances and skin distension test (SDT) for elasticity assessment, and BREAST-Q scores, were collected at time of consultation and compared to preoperative and intraoperative data.</p><p><strong>Results: </strong>Our study's sample shows a mean age of 42 years. Mean follow-up is 13 years, with 18 years as the longest follow-up registered. Mean breast tissue volume removed is 1134 g. A positive correlation between smoking habit and inferior pole elongation is shown (p = 0.031), and between smoking habit and inferior pole skin distension (p=0.002). A significative positive correlation between age and almost all the BREAST-Q scales score is reported.Smoking patients had a higher SN-N distance variation over time and superior pole skin distension.</p><p><strong>Conclusions: </strong>Intrinsic and extrinsic factors may affect outcome and satisfaction irrespective of the age. This versatile procedure demonstrates reliability across time offering enduring results.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Three-Dimensional Computed Tomography Angiography for Safer Filler Injections in Lying Ear Corrections: Identifying Key Vascular Structures\".","authors":"Chen Dong, Chun-Lin Chen, Chao-Yang Chen, Li Tang, Ge-Ge Cao, Cheng-En Luo, Hai-Bin Wang","doi":"10.1097/PRS.0000000000012107","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012107","url":null,"abstract":"<p><strong>Background: </strong>Concerns exist regarding potential complications associated with injectable cosmetic treatments for lying ear correction. This study aimed to examine the blood vessel distribution patterns in the ear and face related to ear filler procedures and surgeries by using three-dimensional computed tomography angiography of cadaveric head specimens.</p><p><strong>Methods: </strong>In total, 50 high-resolution images of the lateral aspects of the specimens were captured. Three-dimensional images of blood vessels in the cephalo-auricular sulcus were created using Mimics. The coordinate system was established based on the highest points of the bilateral external auditory canals and the left suborbital border point, corresponding to the Frankfurt plane. The posterior cephalo-auricular region was divided into regions A, B, C, and D, with region C further subdivided into regions C1 and C2.</p><p><strong>Results: </strong>The primary blood supply to the cephalo-auricular sulcus comes from the medial temporal artery, posterior auricular artery (PAA), and superior auricular artery. Two hypovascular regions, referred to as regions B and C1, were observed between the cephalo-auricular sulcus and the PAA. The measured distances from the PAA to the cephalo-auricular sulcus at three evenly spaced points in region B and at the inferior point of region C1 were 5.6±1.5 mm, 8.8±2.1 mm, 10.7±1.9 mm, and 10.1±2.2 mm, respectively.</p><p><strong>Conclusions: </strong>Regions A, C2, and D pose a higher risk for filler injections, whereas regions B and C1 are relatively safer. This study provides valuable insights into the safe administration of filler injections for correction of lying ears.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Facial Palsy Treatment: A Systematic Review and Recommendations.","authors":"Seraina L C Müller, Pablo Pfister, Nadia Menzi, Laurent Muller, Holger J Klein, Riccardo Schweizer, Z-Hye Lee, Branislav Kollar, Steffen U Eisenhardt, Dirk J Schaefer, Tarek Ismail","doi":"10.1097/PRS.0000000000012105","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012105","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is rapidly advancing and increasingly applied in facial palsy research. However, there is no comprehensive review to guide surgeons on AI-based facial assessment tools. While photographic standards exist, videographic standards for emotions have not been proposed. Implementing these standards is essential for improving information exchange and data comparison with the new AI tools.</p><p><strong>Methods: </strong>We conducted a systematic review following the PRISMA guidelines, by analyzing databases including Medline, Embase, and the Cochrane Central Register of Controlled Trials. Our focus was on the use of AI-based facial assessment tools in patients with facial palsy who subsequently received intervention or surgery for their facial palsy. Data were evaluated descriptively, and recommendations, including videographic standards, were developed in collaboration with experts from multiple centers.</p><p><strong>Results: </strong>We identified 3,222 articles, 35 of which met the inclusion criteria. Five AI applications analyzed static, dynamic, and chemodenervation procedures in unilateral or bilateral facial palsy. These focused on specific facial landmarks or emotion recognition from photos and videos, but varied in the expressions and emotions analyzed. Five studies provided validation data with either healthy subjects or other outcome measurements. We recommend a minimum videographic assessment including the validated emotions neutral and happy.</p><p><strong>Conclusion: </strong>AI-related publications on facial palsy have significantly increased, but no consensus exists on the optimal AI-assessment software. The proposed flowchart from our systematic review can guide clinicians in decision-making. We recommend using the proposed videographic emotions to improve study consistency and comparability, while also encouraging further validation studies.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic Drain Use in Breast Expander-to-Implant Exchange: Necessity or Nuisance?","authors":"Rami Elmorsi, Jose E Barrera, Carrie Chu, Mark W Clemens, Patrick B Garvey, Matthew M Hanasono, J Bryce Olenczak, Alexander F Mericli","doi":"10.1097/PRS.0000000000012101","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012101","url":null,"abstract":"<p><strong>Introduction: </strong>Although drain placement is widely used during the tissue expander stage of implant-based breast reconstruction (IBBR), it is unclear whether surgical drains are necessary at the expander-to-implant exchange stage. We sought to define clinical scenarios in which drains should and should not be used.</p><p><strong>Methods: </strong>We retrospectively analyzed breast expander-to-implant exchanges performed from 2018 to 2023 and compared complication rates between patients treated with and without drains. Patients' demographic, disease, treatment, and outcome data were recorded. Genetic propensity score matching was used to mitigate selection bias. Multivariable binary logistic regression identified significant predictors of complications.</p><p><strong>Results: </strong>In unmatched comparisons, rates of overall complications, implant exposure, and implant explantation were significantly higher in the drain group versus the no-drain group (12% vs. 4.7%, 2.5% vs. 0.3%, and 8.5% vs. 2.6%, respectively, p < 0.05). This was particularly evident in the prepectoral plane, where overall complication (11% vs. 4.3%, p = 0.014), implant exposure (2.2% vs. 0%, p = 0.047), and implant explantation (6.7% vs. 2.2%, p = 0.041) rates were significantly higher with drains. However, propensity score-matched comparisons, stratification by concomitant ancillary procedures, and multivariable logistic regression showed that drain placement was neither predictive of nor protective against postoperative complications.</p><p><strong>Conclusion: </strong>Surgical drains do not protect against adverse outcomes in the second stage of IBBR, even with ancillary procedures, and may contribute to higher complication rates, particularly in the prepectoral plane. However, patients with a heavy dissection burden, extensive capsular manipulation or resection, or comorbidities may benefit from drain placement.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial Reanimation in Complete Moebius Syndrome Using Bilateral Free Gracilis Muscle Transfer: A Comparison of One-Stage Versus Two-Stage Procedures.","authors":"Kenzo Alejandro Fukumoto-Inukai, Damián Palafox, Enrique Chávez-Serna, Nancy Adriana Mendoza-Molina, Valentina Prieto-Vargas, José Eduardo Telich-Tarriba, Alexander Cárdenas-Mejía","doi":"10.1097/PRS.0000000000012106","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012106","url":null,"abstract":"<p><strong>Background: </strong>Complete Moebius Syndrome (CMS) is a congenital condition affecting the VII and VI cranial nerves, causing bilateral facial paralysis and limited ocular abduction. Bilateral free gracilis muscle transfer (FGMT) is the standard treatment. Traditionally performed in two stages, a new one-stage approach has been introduced at our center. This study compares the surgical and long-term outcomes of both methods in CMS patients.</p><p><strong>Methods: </strong>This retrospective cohort study included CMS patients who underwent one-stage or two-stage bilateral FGMT between March 2016 and June 2024, with a median follow-up of 8.1 years (range: 2-19 years). We evaluated sociodemographic characteristics, perioperative/postoperative parameters, total costs, satisfaction, and long-term aesthetic and functional outcomes. Statistical analyses included chi-square and Mann-Whitney U tests, with significance at p < 0.05.</p><p><strong>Results: </strong>Eighteen CMS patients underwent 36 FGMT procedures: nine in Group 1 (one-stage) and nine in Group 2 (two-stage). The median age was 15 years (6-36 years), and 61.1% were women. No significant differences were observed in postoperative complications such as flap loss (p=0.303), hematoma (p=0.058), surgical site infections (p=0.134), or flap revision (p=0.257). Group 2 had longer surgeries (p=0.050), extended hospital stays (p=0.001), and higher costs (p=0.001). Aesthetic and functional outcomes were similar between the groups (p= >0.05).</p><p><strong>Conclusions: </strong>One-stage bilateral free gracilis muscle transfer (FGMT) is as effective as the two-stage approach in CMS patients. The one-stage procedure is more cost-effective, with shorter surgeries, reduced hospital stay, and lower patient costs. Both surgical methods demonstrated similar long-term aesthetic and functional outcomes.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cleft photo mirror combining self-retraction, scaling, and anti-fogging features for cleft palate documentation.","authors":"Prasad Nalabothu, José Wittor de Macêdo Santos, Benito K Benitez, Yoriko Lill, Sebastian Tapia Coron, Andreas A Mueller","doi":"10.1097/PRS.0000000000012099","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012099","url":null,"abstract":"<p><strong>Summary: </strong>Documentation of patients with cleft lip and palate (CLP) presents a significant challenge due to the necessity for consistent, high-quality imaging throughout the extended treatment period. The use of traditional intraoral mirrors typically necessitates an assisting person for retraction of the lips, and cheeks, and mirror fogging cleaning. This results in variable fields of view and high personal resources. Distance measurements are not possible on conventional photographs, limiting their use for objective treatment analysis. To address these three challenges at once, we developed a customized intraoral mirror incorporating self-retraction, a reference scale, and an anti-fogging option. The mirror design features lateral extensions for effective lip and cheek retraction and two small laser-engraved black triangles, spaced 2 cm apart at the end of the mirror to measure the width of the cleft, enabling a single operator to independently capture clear images. The mirror is designed in four sizes to accommodate patients from newborn babies to adults. Clinical implementation demonstrated that the mirror allows the acquisition of high-quality standardized images without additional assistance enhancing workflow efficiency and consistency in documentation. By overcoming the limitations of traditional mirrors, our mirror provides a practical and efficient solution for CLP documentation. It facilitates accurate follow-up of treatment progress beyond orthodontic and surgical evaluation.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications and Patient-Reported Outcomes in Prepectoral vs Submuscular Breast Reconstruction Following Nipple Sparing Mastectomy.","authors":"Jennifer Wang, Ronnie L Shammas, Elizabeth Montes-Smith, Lillian A Boe, Jacob Levy, Francis D Graziano, Carrie S Stern, Jonas A Nelson, Joseph J Disa","doi":"10.1097/PRS.0000000000012096","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012096","url":null,"abstract":"<p><strong>Background: </strong>Preprectoral breast reconstruction and nipple-sparing mastectomy (NSM) have both risen in popularity due to advances in reconstructive techniques. However, it is unknown whether exposed lactiferous ducts in a NSM may increase the risk for infection after prepectoral implant-based breast reconstruction. We aimed to assess complication rates and BREAST-Q Physical Well-Being of the Chest (PWBC) scores in patients who underwent NSM and implant-based breast reconstruction in a prepectoral vs. submuscular plane.</p><p><strong>Methods: </strong>A retrospective review was performed of patients who underwent NSM with two-stage implant-based reconstruction from 2013-2023. Patients were grouped by prepectoral or submuscular placement. Post-operative complications and BREAST-Q scores were assessed after surgery.</p><p><strong>Results: </strong>693 patients were included; 345 underwent prepectoral and 348 underwent submuscular reconstruction. Surgical site infection occurred in 10% of prepectoral patients and 5.7% of submuscular patients (p=0.03). Seroma occurred in 15% of prepectoral patients and 6.6% submuscular patients (p<0.001). Multivariable analysis showed prepectoral patients had significantly increased odds of developing surgical site infection and seroma compared to submuscular patients (Odds ratio [OR] 1.87, p=0.04 and OR 2.52, p<0.001, respectively). However, prepectoral reconstruction was associated with significantly higher BREAST-Q PWBC scores as compared to submuscular implant placement (β=3.4, p=0.01).</p><p><strong>Conclusions: </strong>Prepectoral reconstruction following NSM is associated with higher rates of surgical site infection and seroma but improved physical well-being of the chest compared to submuscular implant placement following NSM. An increased risk of infection and seroma should be weighed against improved patient-reported outcomes when deciding on implant plane placement after NSM.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female Genital Mutilation Reconstruction: Surgical Technique.","authors":"Sarah L Barnett, Elizabeth B Card, Ashley Chang, Ivona Percec","doi":"10.1097/PRS.0000000000012097","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012097","url":null,"abstract":"<p><strong>Summary: </strong>Female Genital Mutilation (FGM) reconstruction has been shown to be a safe procedure that contributes to improvements in physical and emotional sexual health. Genital reconstructive procedures are increasing in demand, but access to these surgeries is severely limited. This represents an opportunity for plastic surgeons to leverage their reconstructive expertise in delivering both functional and aesthetic rehabilitation to FGM survivors. The accompanying educational video demonstrates FGM reconstructive surgery, which consists of adjacent tissue rearrangement of the bilateral vulva with buccal mucosal grafting and structural fat grafting. First, buccal mucosa grafts are designed and harvested to allow sufficient coverage of the defect to be restored. Local anesthetic infiltration and fat graft harvest are performed in the superior mons area. An inverted Y incision is used to create de novo labia minora flaps and dissect the clitoral remnant. Vaginal sulci are recreated with imbrication of labia majora. The buccal grafts are shaped to resurface the defects and secured using bolsters fashioned out of Doyle splints covered with antibiotic ointment. Fat grafting is performed bilaterally into the labia majora and mons region, to provide protection and a conductive environment for sensory regeneration of the clitoral remnant. This technique produces an excellent improvement in contour, release of scar tissue, and labia minora reconstruction with a low complication rate. Post-operatively, patients have experienced a return in natural pigmentation and clitoral sensation. This straightforward, effective approach has been shown to improve physical, sexual, and psychological health in FGM survivors.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Prophylactic Mastectomy and Autologous Flap Reconstruction in BRCA1/2+ Patients: A Markov Chain Monte Carlo Simulation Analysis.","authors":"Reid W Smith, Sneha Subramaniam, Jagmeet S Arora, Isabelle T Smith, Neil Tanna, Clifford C Sheckter, Mark L Smith","doi":"10.1097/PRS.0000000000012094","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012094","url":null,"abstract":"<p><strong>Introduction: </strong>Patients diagnosed with Breast Cancer gene (BRCA) 1 or 2 face a critical choice between prophylactic mastectomy versus serial surveillance screening. This study aims to evaluate the cost-effectiveness of prophylactic mastectomy with autologous reconstruction compared to surveillance strategies for this patient population.</p><p><strong>Methods: </strong>Markov Chain Monte Carlo (MCMC) simulations comprising 100,000 patients were used. All models assumed a baseline of women aged 25 with BRCA1 or BRCA2 mutations. In the standard of care model, patients underwent annual screening (MRI+Mammography) until 75. Positive screenings led to mastectomy followed by two-stage breast reconstruction using tissue expanders-to-implants. This approach was compared to prophylactic mastectomy with autologous flap reconstruction (free-TRAM, gluteal, thigh, or DIEP) at ages 30, 35, or 40. Evaluation parameters included cost, quality of life, and incremental cost-effectiveness ratios (ICER).</p><p><strong>Results: </strong>All autologous flaps ICERs were below the willingness-to-pay threshold of $50,000, suggesting cost-effectiveness, with DIEP flaps being the lowest. Prophylactic mastectomy with autologous reconstruction was more cost effective for BRCA1 than BRCA2 patients and sensitivity analysis revealed that prophylaxis became cost-effective earliest for DIEP flaps (50-63) and latest for gluteal flaps (58-73).</p><p><strong>Conclusion: </strong>Prophylactic mastectomy with autologous reconstruction performed at ages 30, 35 or 40, was found to be a cost-effective alternative to breast cancer surveillance and disease treatment in women with BRCA1/2 mutations. DIEP and free TRAM flaps were the most cost-effective techniques and prophylaxis was more cost effective in BRCA1 than BRCA 2 patients.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peering behind the curtain of electrodiagnostic testing.","authors":"Sandra L Hearn, Cody C Andrews, Kevin C Chung","doi":"10.1097/PRS.0000000000012087","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012087","url":null,"abstract":"<p><strong>Summary: </strong>An electrodiagnostic (EDX) consultation, by measuring nerve function directly and objectively, assesses disorders of the peripheral nervous system. An understanding of how electrodiagnosis gleans relevant information can help surgeons make effective referrals and apply the results to guide patient care.An EDX consultation is tailored to the clinical impression and adjusted dynamically to evaluate specific impairments and distinguish between differential diagnoses. The EDX study comprises nerve conduction studies (NCS) and electromyography (EMG). With NCS, sensory and motor nerve fascicles are assessed for focal or generalized slowing of action potential conduction (which can suggest demyelination), conduction block, and amplitude loss (which can suggest axonal loss). The motor components are most useful when planning nerve reconstruction, as the recorded amplitudes can evaluate of presence of conduction block and estimate extent of axonal loss in the innervation of key muscles. The EMG component is qualitative, assessing an array of muscles using a needle electrode that detects small amounts of recent or active axonal loss (presence of fibrillations) and gauges the degree and extent of reinnervation.Accordingly, electrodiagnosis can provide information on lesion localization, underlying pathophysiology, extent of nerve injury, time course, and reinnervation status. Where clinical recovery is questionable, including before or after nerve reconstruction, they can evaluate for early reinnervation and inform prognosis for recovery.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}