JPRAS Open最新文献

{"title":"Role of residual mandibular teeth after computer-assisted mandibular reconstruction using a fibular flap","authors":"Koreyuki Kurosawa ,&nbsp;Akira Ohkoshi ,&nbsp;Ryo Ishii ,&nbsp;Naoko Sato ,&nbsp;Hitoshi Miyashita ,&nbsp;Takayuki Harata ,&nbsp;Toshiro Imai ,&nbsp;Masanobu Hayashi ,&nbsp;Shinyo Ishi ,&nbsp;Miki Shoji ,&nbsp;Yoshimichi Imai","doi":"10.1016/j.jpra.2024.10.002","DOIUrl":"10.1016/j.jpra.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Computer-assisted mandibular reconstruction after mandibulectomy enables accurate reconstruction of the occlusal positions between the maxilla and mandible. Understanding the remaining teeth condition is essential for sensory mastication in patients with numerous tooth loss. However, no studies have examined the dental status of the remaining mandible after computer-assisted mandibular reconstruction using a fibular flap. This study evaluated the role of residual teeth and other factors in effective acquisition of oral intake after computer-assisted mandibular reconstruction using a fibular flap.</div></div><div><h3>Patients and Methods</h3><div>Postoperative oral intake and associated factors were retrospectively examined in 57 consecutive patients. Oral intake was assessed using the Functional Oral Intake Scale. Multivariate analysis was performed to evaluate the remaining teeth arrangement (Eichner's classification), mandibular dentures, extent of resection (Brown's classification), age, performance of glossectomy, history of radiation therapy, and computer-assisted methods.</div></div><div><h3>Results</h3><div>Multivariate analysis revealed that Eichner's classification had a positive (p&lt;0.001) and radiation therapy had a negative (p&lt;0.05) impact on oral intake. The patients with dentures anchored to the remaining teeth in the occlusal support area (i.e., premolar and molar) had higher Functional Oral Intake score than those with dentures anchored to the remaining teeth in the non-occlusal support area (6.78±0.03 vs. 6.10±0.07, p&lt;0.005).</div></div><div><h3>Conclusion</h3><div>In computer-assisted mandibular reconstruction with accurate occlusion, the residual teeth in the occlusal support area are essential for good postoperative oral intake with dentures. During mandibulectomy, if oncologically acceptable, these teeth should be preserved, and selective placement of dental implants in the occlusal support area should be considered.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 350-360"},"PeriodicalIF":1.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe facial trauma secondary to aircraft propeller injury: The art of facial reconstruction","authors":"Yusef Jiménez-Murat ,&nbsp;Kevin Fuentes-Calvo ,&nbsp;Kenzo A. Fukumoto-Inukai ,&nbsp;Rogelio Martínez-Wagner","doi":"10.1016/j.jpra.2024.10.004","DOIUrl":"10.1016/j.jpra.2024.10.004","url":null,"abstract":"<div><div>The reconstruction of complex facial trauma poses a significant challenge for plastic surgeons, as it requires a multidisciplinary approach to achieve both functional and aesthetic outcomes. Moreover, it represents a substantial burden on public health. In severe facial trauma, initial management to rule out life-threatening conditions through Advanced Trauma Life Support (ATLS) is crucial. Expertise in soft tissue reconstruction and facial fracture management is essential to achieve good results. New reconstruction techniques include free flaps, grafts, expanders, and epidermal grafts.</div><div>Here, we present the case of a 68-year-old male who suffered facial trauma from an aircraft propeller managed through staged reconstructive surgical techniques. We will describe surgical management, emphasizing the methods and outcomes. The primary objective of this study is to provide insights into the clinical challenges and therapeutic strategies in managing severe facial trauma, underscoring the critical importance of an interdisciplinary approach to achieve successful and functional facial reconstruction.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 338-343"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the quality and reliability of oncologic breast reconstruction videos on youtube","authors":"Daniel Soroudi ,&nbsp;Israel Falade ,&nbsp;Nina Mehta ,&nbsp;Alexis Gursky ,&nbsp;Raymond Yin ,&nbsp;Siyou Song ,&nbsp;Esther Kim","doi":"10.1016/j.jpra.2024.10.006","DOIUrl":"10.1016/j.jpra.2024.10.006","url":null,"abstract":"<div><div>Oncologic breast reconstruction (OBR) is a complex process that requires consideration of multiple factors, including chemoradiation, extent of cancer treatment, and surgical approach. Patients often feel uncertain about the numerous surgical options and may turn to popular social media platforms like YouTube for information. Thus, this study aims to assess the quality and reliability of YouTube videos related to OBR.</div><div>We conducted a retrospective, cross-sectional analysis of YouTube videos related to OBR. Search terms were obtained from <span><span>plasticsurgery.org</span><svg><path></path></svg></span> and Google Trends. The first ten videos for each search term were analyzed. Videos were categorized by source and subject matter and independently reviewed by three evaluators using the DISCERN scale.</div><div>This study examined 172 YouTube videos. Five video source categories were identified: Health Care Administrations, Physicians, Non-physician Providers, News Organizations, and Patients. Health Care Administration accounts received the highest overall DISCERN score of 3.6 ± 0.51, followed by Physicians at 2.98 ± 0.93, with News Organization accounts scoring the lowest at 2.22 ± 0.60 (<em>p</em> &lt; 0.001). Videos from academic sources (Physicians and Health Care Administrators) had higher DISCERN scores compared to non-academic sources (News Organizations and Patients), 2.98 ± 0.95 versus 2.28 ± 0.77, respectively (<em>p</em> &lt; 0.001).</div><div>Our findings indicate that videos from academic sources generally exhibit higher DISCERN scores, pointing to a higher content quality and reliability standard. Given the increasing reliance on YouTube for healthcare information, our study underscores the need for healthcare professionals to engage more actively in content creation and dissemination.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 311-314"},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Lymphatic vessels preserving descending genicular artery perforator (LpDGAP) flap for a skin defect on the anterior knee: A single case report”","authors":"Yushi Suzuki,&nbsp;Tatsuya Kato,&nbsp;Noriko Seguchi,&nbsp;Kazuo Kishi","doi":"10.1016/j.jpra.2024.09.018","DOIUrl":"10.1016/j.jpra.2024.09.018","url":null,"abstract":"<div><div>The medial thigh, rich in lymphatic vessels, presents risks of seroma and lymphoedema after flap elevation. This study discusses a novel approach using indocyanine green (ICG) to preserve lymphatic vessels while harvesting a descending genicular artery perforator (DGAP) flap for knee reconstruction. Here, we present the case of a 44-year-old woman who developed a skin defect below the right knee after cellulitis and abscess debridement. Preoperative ICG lymphography identified the lymphatic pathways, allowing for a meticulous flap design to avoid vessel damage. The surgery resulted in successful flap integration and a full range of knee motion without complications. Follow-up ICG lymphography confirmed the preservation of the lymphatic vessels. This case underscores the importance of lymphatic preservation in medial thigh flap procedures to minimise postoperative complications, such as seroma, cellulitis, and transient lymphoedema. Further research is required to explore the applications of this technique in broader clinical settings.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 250-255"},"PeriodicalIF":1.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Efficacy and Complications of the Scapular Osseous Free Flap for Head and Neck Reconstruction: Results from a Population-based Cohort","authors":"Henrik Guné ,&nbsp;Johanna Sjövall ,&nbsp;Magnus Becker ,&nbsp;Karin Elebro ,&nbsp;Anna Hafström ,&nbsp;Linda Tallroth ,&nbsp;Stina Klasson","doi":"10.1016/j.jpra.2024.09.020","DOIUrl":"10.1016/j.jpra.2024.09.020","url":null,"abstract":"<div><h3>Introduction</h3><div>The scapular osseous free flap (SOFF) is being increasingly used for complex head and neck reconstructions. This study examined the surgical outcomes, focusing on post-operative complications and sequelae in patients who underwent SOFF for maxillary and mandibular reconstructions.</div></div><div><h3>Material and Methods</h3><div>This retrospective, observational, population-based study included patients who underwent SOFF reconstruction at a tertiary referral centre, the Department of Otorhinolaryngology-Head and Neck Surgery, Skåne University Hospital, Sweden, from November 2016 to March 2023. All patients were followed-up for at least six months after surgery.</div></div><div><h3>Results</h3><div>Forty-two of the 44 consecutive patients (60 % men) consented to the study and were evaluated with a median follow-up time of 49 months (range 8–85 months). The study divided the patients into two groups; maxillary (<em>n</em> = 29) and mandibular (<em>n</em> = 13) reconstructions. The World Health Organisation performance status and the Charlson comorbidity index were lower in the maxillary group (<em>p</em> = 0.025 and <em>p</em> = 0.011, respectively). The maxillary group experienced high complication rates including six total flap failures and nine oronasal fistulas. Conversely, the mandibular group had no flap failures but a similar rate of general post-operative complications were observed. Dental rehabilitation was more common in the maxillary group.</div></div><div><h3>Conclusion</h3><div>The SOFF is an option for complex reconstructions of the maxilla but is associated with a relatively high rate of complications. Methods that can prevent or minimise sequelae, e.g., oronasal fistulas, in future patients are warranted. The SOFF is an excellent alternative for mandibular reconstructions.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 296-305"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of trunk defects using perforator flaps: A case series introducing suprascapular artery perforator flap","authors":"Sebastian Dietrich ,&nbsp;Irakli Panchulidze","doi":"10.1016/j.jpra.2024.09.015","DOIUrl":"10.1016/j.jpra.2024.09.015","url":null,"abstract":"<div><div>This case series explores the efficacy of freestyle perforator flaps, including the newly introduced suprascapular artery perforator flap (SSAP), in reconstructing trunk defects. Over a five-year period, 24 perforator flap procedures were performed on 19 patients, primarily for defect reconstruction after skin tumor and ulcer resections. Flap design was customized using preoperative doppler ultrasound and they were then transferred to defects in a V-Y or propeller fashion. The most frequently utilized flaps were the dorsal intercostal artery perforator (DICAP) flap and the lumbar artery perforator (LAP) flap. Notably, SSAP flaps were successfully employed for shoulder defects resulting from squamous cell carcinoma resections.</div><div>Complications occurred in 29 % of cases, including seroma evacuation, hematoma, and wound dehiscence, with one patient experiencing severe liver failure post-surgery. The versatility of perforator-based reconstruction was demonstrated through the combination of DICAP and LAP flaps for large trunk defects. Additionally, internal mammary artery perforator (IMAP) and lateral thoracic artery perforator (LTAP) flaps were utilized for parasternal and infraclavicular defects, respectively.</div><div>The introduction of the SSAP flap expands the options for dorsal shoulder area reconstruction, offering faster healing and superior cosmetic results compared to traditional methods like secondary intention healing or skin grafting. Although this study showcases promising outcomes, further research is warranted to validate the effectiveness of SSAP flaps and to explore their applications in a broader patient population.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 268-274"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the accuracy of artificial intelligence in the diagnosis and management of orbital fractures: Is this the future of surgical decision-making?","authors":"Steven Gernandt ,&nbsp;Romain Aymon ,&nbsp;Paolo Scolozzi","doi":"10.1016/j.jpra.2024.09.014","DOIUrl":"10.1016/j.jpra.2024.09.014","url":null,"abstract":"<div><div>Orbital fractures are common, but their management remains controversial. The aim of the present study was to assess the accuracy of an advanced artificial intelligence (AI) model, ChatGPT-4, in surgical decision-making, with a focus on orbital fracture diagnosis and management.</div><div>A retrospective observational analysis was conducted by involving a sample of 30 orbital fracture cases diagnosed and managed at the Geneva University Hospital, Switzerland. The process involved creating patient vignettes from anonymised medical records and presenting them to ChatGPT-4 in three stages: initial diagnosis, refinement with radiological reports and surgical intervention decisions. The performance of ChatGPT-4 in providing the appropriate surgical strategy was evaluated through measures of sensitivity, specificity, positive predictive value and negative predictive value, with the actual management used as the benchmark for accuracy.</div><div>The AI model could correctly diagnose the fracture in 100 % of the cases. It demonstrated a specificity of 100 % and sensitivity of 57 % for treatment recommendation, indicating its effectiveness in recognising patients who truly required an intervention; however, it demonstrated a moderate performance in correctly identifying cases that were better suited for conservative treatment. Cohen's Kappa statistic for interrater reliability of the choice of treatment was 0.44, indicating a weak level of agreement between ChatGPT and the physician's choice of treatment.</div><div>The study demonstrates that AI tools such as ChatGPT-4 can offer a high degree of accuracy in diagnosing orbital fractures and recognising patients requiring surgical intervention; however, it performed less satisfactorily in correctly identifying patients who were better suited for non-surgical treatment.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 275-283"},"PeriodicalIF":1.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrotising cellulitis occurring after cosmetic blepharoplasty: A case report","authors":"Rhyme Timoumi,&nbsp;Laura Moyal,&nbsp;Jean-Philippe Nordmann,&nbsp;Amin Bennedjai","doi":"10.1016/j.jpra.2024.09.016","DOIUrl":"10.1016/j.jpra.2024.09.016","url":null,"abstract":"<div><div>Periorbital necrotising cellulitis is a rare localisation of fasciitis and an exceptional complication of cosmetic blepharoplasty.</div><div>We discuss here the case of a 52-year-old woman who presented with orbital cellulitis 2 days after undergoing a bilateral cosmetic lower blepharoplasty. The diagnosis was confirmed on magnetic resonance imaging. Cellulitis was complicated by ocular hypertension resistant to local treatment and intravenous acetazolamide, leading to a decrease in visual acuity.</div><div>Infection management consisted of intravenous antibiotics, corticosteroid bolus and drainage surgery. Bacteriological samples yielded <em>Staphylococcus epidermidis</em> resistant to all betalactamines. Anatomopathological analysis of the drained sample revealed an aspect compatible with necrotising cellulitis.</div><div>To our knowledge, this is the seventh case of necrotising cellulitis occurring after blepharoplasty reported in the literature. The other cases were due to the virulent <em>Streptococcus pyogenes</em> and required surgical debridement and antibiotics. Our case is unique, as it is the first reported case of necrotising cellulitis due to another pathogen, <em>Staphylococcus epidermidis</em>, which appears less virulent.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 306-310"},"PeriodicalIF":1.5,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Submental flap: A reconstructive option in head and neck surgery","authors":"Vincenzo Filomena ,&nbsp;María Antón Almero ,&nbsp;Eduardo Ferrandis Perepérez","doi":"10.1016/j.jpra.2024.09.019","DOIUrl":"10.1016/j.jpra.2024.09.019","url":null,"abstract":"<div><h3>Objective</h3><div>The submental flap is a fasciocutaneous flap used in head and neck reconstruction. The aim of this study was to share the indications and outcomes of submental flap reconstruction based on our experience.</div></div><div><h3>Methods</h3><div>A retrospective descriptive study was conducted on a group of 14 patients who underwent reconstructive surgery of the orofacial region with the submental flap. All reconstructions were performed following oncologic resections.</div></div><div><h3>Results</h3><div>The submental flap was employed for the reconstruction of mobile tongue in 5 cases, maxilla and hard palate in 4 cases, cheek in 2 cases, floor of the mouth in 1 case, retromolar trigone in 1 case and oropharyngeal defects in 1 case. Satisfactory oral cavity opening was achieved in all cases. No transfer of metastatic lymph nodes to the recipient area was detected in this study.</div></div><div><h3>Conclusions</h3><div>The submental flap significantly shortens the surgical time compared to microvascular flaps. In our experience, the necessity for neck lymph node surgery does not preclude the use of the submental flap. Meticulous dissection of the flap greatly reduces the risk of potential transfer of tumours through the flap to the recipient area.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 284-291"},"PeriodicalIF":1.5,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed unilateral eyelid oedema following non-periocular hyaluronic acid injection: A case report and literature review","authors":"Cecilia Soldini ,&nbsp;Luigi Schiraldi ,&nbsp;Pietro Giovanni Di Summa","doi":"10.1016/j.jpra.2024.09.017","DOIUrl":"10.1016/j.jpra.2024.09.017","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"42 ","pages":"Pages 334-337"},"PeriodicalIF":1.5,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}