• Title/Summary/Keyword: Soft-tissue defect

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Interim palatal lift prosthesis as a constituent of multidisciplinary approach in the treatment of velopharyngeal incompetence

  • Raj, Neerja;Raj, Vineet;Aeran, Himanshu
    • The Journal of Advanced Prosthodontics
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    • v.4 no.4
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    • pp.243-247
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    • 2012
  • The velopharynx is a tridimensional muscular valve located between the oral and nasal cavities, consisting of the lateral and posterior pharyngeal walls and the soft palate, and controls the passage of air. Velopharyngeal insufficiency may take place when the velopharyngeal valve is unable to perform its own closing, due to a lack of tissue or lack of proper movement. Treatment options include surgical correction, prosthetic rehabilitation, and speech therapy; though optimal results often require a multidisciplinary approach for the restoration of both anatomical and physiological defect. We report a case of 56 year old male patient presenting with hypernasal speech pattern and velopharyngeal insufficiency secondary to cleft palate which had been surgically corrected 18 years ago. The patient was treated with a combination of speech therapy and palatal lift prosthesis employing interim prostheses in various phases before the insertion of definitive appliance. This phase-wise treatment plan helped to improve patient's compliance and final outcome.

An Adult Right-sided Bochdalek Hernia Accompanied with Hepatic Hypoplasia and Inguinal Hernia

  • Choi, Yun Kyung;Ahn, Jae Ho;Kim, Kwan Chang;Won, Tae Hee
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.348-350
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    • 2012
  • We herein report a very rare case of adult right-sided Bochdalek hernia accompanied with hepatic hypoplasia and inguinal hernia. A 29-year-old man was admitted with right-sided pneumothorax. A computed tomography was performed and revealed large right sided Bochdalek hernia with hepatic hypoplasia. Under thoracolaparotomy, the defect was closed with Gore-Tex soft tissue patch. After the operation, left-sided inguinal hernia was found. However, it turned out that it had been present during infancy and spontaneously resolved during adolescence. This is the first report of right-sided Bochdalek hernia with hepatic hypoplasia and inguinal hernia in an adult.

Ileocecocolic and Colocolic Intussusception in a Young Jindo

  • Jung, Joo-Hyun;Chae, Woong-Joo;Kwon, Do-Hyoung;Chang, Jin-Hwa;Oh, Sun-Kyoung;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.25 no.6
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    • pp.549-552
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    • 2008
  • An eight-month-old, intact female Jindo, weighing 9 kg with a one-day history of acute bloody diarrhea was referred. Plain abdominal radiographic findings included evidence of a soft tissue tubular mass within the dilated colon. In ultrasonographs, a target-like mass was identified with multiple hyperechoic and hypoechoic parallel wall layers. A barium enema showed a large radiolucent filling defect within the colon and a completely occlusive lumen. On the basis of these images, ileocecocolic and colocolic intussusception was diagnosed. Surgical manual reduction, resection and anastomosis were performed. The patient recovered normally without any complications or recurrence.

A Clinical Experience of Neurofibromatosis Involving Periorbital Region (안와부위에 발생한 신경섬유종증의 임상적 치험례)

  • Park Dae-Hwan;Kim Tae-Mo;Han Dong-Gil;Ahn Ki-Young
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.86-89
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    • 1997
  • Neurofibromatosis, now termed neurofibromatosis type I, is known as a congenital and familial disease presenting abnormalities of the skin, nervous system, bones, and soft tissue. We experienced a case of extremely large neurofibromatosis which developed on the orbital and temporal region of a 24-year-old man. The tumor was widely excised including normal skin margin, outer table of cranium, a part of zygoma and maxilla. Bony defect was reconstructed by rib bone graft and secondary cosmetic correction of blepharoptosis was performed using supratarsal fixation in postoperative 6 months.

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Rectal Perforation Associated with a Pelvic Fracture Managed with Lateral Caudal Axial Pattern Flap Surgery Using the Tail to Skin Defect in a Mixed-Breed Dog

  • Lee, Jongjin;Kang, Jinsu;Kim, Namsoo;Heo, Suyoung
    • Journal of Veterinary Clinics
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    • v.38 no.5
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    • pp.240-243
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    • 2021
  • Complications of pelvic fractures and sacroiliac joint luxation include hemoabdomen, pulmonary trauma, and soft tissue injury. Among them, rectal perforation accounts for 1% of pelvic fracture complications. Delayed diagnosis is commonly associated with a poor prognosis. A mixed-breed dog was presented to Jeonbuk Animal Medical Center (JAMC) after a traffic accident with no signs of rectal perforation. After fracture surgery, rectal perforation was seen as a perianal fistula. This report describes a case of a perianal fistula progressed from rectal perforation after a traffic accident that was curatively treated with lateral caudal axial pattern flap surgery to the perianal skin.

Bilateral Free 2ndToe Pulp Flap for Reconstruction of Soft Tissue Defect in Traumatic Finger Injuries

  • Oh, Jeongseok;Eun, Seok Chan
    • Journal of Trauma and Injury
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    • v.32 no.3
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    • pp.181-186
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    • 2019
  • Finger reconstruction involves paramount significance of both functional and aesthetic aspects, due to its great impact on quality of life. The options range from primary closure, skin grafts, local flaps, pedicled flaps, and free flaps. The optimal method should consider various circumstances of the patient and surgeon. We would like to report a case of a young woman who initially presented with cellulitis and necrosis of the left second finger-tip who underwent reconstruction with bilateral toe pulp free flap. The patient could successfully return to her job that involves keyboard typing and playing the piano, with acceptable donor site morbidity.

Acellular dermal matrix and bone cement sandwich technique for chest wall reconstruction

  • Heo, Chan Yeong;Kang, Byungkwon;Jeong, Jae Hoon;Kim, Kwhanmien;Myung, Yujin
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.25-28
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    • 2022
  • The authors performed rigid reconstruction using the sandwich technique for full-thickness chest wall defects by using two layers of acellular dermal matrix and bone cement. We assessed six patients who underwent chest wall reconstruction. Reconstruction was performed by sandwiching bone cement between two layers of acellular dermal matrix. In all patients, there was no defect of the overlying soft tissue, and primary closure was performed for external wounds. The average follow-up period was 4 years (range, 2-8 years). No major complications were noted. The sandwich technique can serve as an efficient and safe option for chest wall reconstruction.

Reconstruction with Anterolateral Thigh Free Flap in Substitute for Radial Forearm Free Flap with Vascular Variation (유리전완피부피판의 혈관변이로 인해 전외측 대퇴유리피판을 대체 적용한 구강 내 재건 증례)

  • Yoon, Sang-Yong;Kim, Sung-Hee;Song, Jae-Min;Lee, Ju-Min;Nam, Su-Bong;Kim, Uk-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.4
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    • pp.248-255
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    • 2013
  • Reconstruction techniques of orofacial defects caused by wide excision of the intraoral malignant lesions are various. Although radial forearm free flap is a common donor site on reconstruction of soft tissue defect, anterolateral thigh (ALT) free flap also has an established site in orofacial soft tissue reconstruction as the favored donor flap with recent progress of the microsurgical technique. A 59-year-old female complained of hyperplastic mass on the right retromolar and buccal cheek, which was diagnosed as a squamous cell carcinoma (SCC) by an incisional biopsy. Before the operation, we planned a wide excision of the SCC lesion, supraomohyoid neck dissection, reconstruction with radial forearm free flap (RFFF), and split thickness skin graft. We accidentally found an arterial variation of the forearm area during elevation of RFFF, and changed the plan of reconstruction operation to reconstruction with ALT free flap. Operative sites was healed well during the post-operative period, and we referred to the department of radiation oncology for post-operative radiotherapy.

Reliability of the Anterior Thigh Free Flap for Reconstruction of the Extremities (상하지 재건을 위한 유리피판 공여부로서 전측대퇴부의 신뢰성)

  • Park, Ji-Ung;Cho, Sang-Hun;Eo, Su-Rak
    • Archives of Reconstructive Microsurgery
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    • v.16 no.1
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    • pp.39-47
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    • 2007
  • With the advent of microsurgery, perforator free flap is nowadays considered the first choice for reconstruction of the extensive defect of the extremities because of their moderate thickness. Among them, anterior (anterolateral and anteromedial) thigh perforator free flaps provide the first choice for reconstruction of various soft tissue defects of the extremities with many advantage such as its large, uniform thickness, long vascular pedicle with proper vessel size and minimal donor site morbidity. But, it has still some criticism of unreliable perforators which makes us very careful in elevating the flap. Between March of 2006 and February of 2007, we treated 7 patients of soft tissue defects in the hand and lower extremities with anterior thigh perforator free flap at Hallym and DongGuk University Hospital. We performed 6 anterolateral thigh perforator free flaps based on the descending branch of lateral circumflex femoral artery (LCFA) and 1 anteromedial thigh perforator free flap based on the innominate branch of the LCFA. While approaching for the anterolateral thigh free flap, we happen to meet the cases which we should change into the anteromedial thigh free flap uneventfully on the operating field. In contrast to the original design of anterolateral thigh free flap, we had to harvest the anteromedial thigh perforator free flap in 1 case. All the anterior thigh perforator free flaps survived completely except 1 case of partial necrosis due to venous congestion. Donor sites were closed primarily and healed uneventfully within 2 weeks. Patients were satisfied with the functionally and aesthetically acceptable results. Although doppler sonography is strongly recommended preoperatively in planning the anterior thigh perforator free flaps, we should always remember the variation in vascular anatomy and be ready to change the flap choice from the anterolateral to anteromedial intraoperatively. we provide a review of the literature and present our series of anterior thigh perforator free flaps for reconstruction of the extremities.

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Reverse Anterolateral Thigh Flap to Reconstruct a Below-Knee Amputation Stump: Two Case Reports

  • Chung, Duke-Whan;Han, Chung-Soo;Lee, Jae-Hoon;Hong, Se-Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.51-56
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    • 2011
  • During below knee amputation, the amputation stump must be covered with well-vascularized and sensate soft tissue. Many flaps can be used for this purpose, but available reconstructive options are limited. We performed reverse flow ALT flap elevation on two patients with below knee amputations to reconstruct defects in the stumps. The sizes of the defects in the stumps were $4{\times}16$ cm and $5{\times}5$ cm, respectively. The most distal portion of the defects were located 20 cm and 16 cm lateral to the knee joint in a curve, respectively. The size of the elevated flap was $5{\times}18$ cm for case 1 and $18{\times}10$ cm for case 2. The respective pivot points of the pedicles were 7 cm and 6 cm above the patella and the respective lengths of the pedicles were 17 cm and 16 cm. In both cases, venous congestion occurred on the second postoperative day and the flap distal to 10 cm or more from below the knee joint was necrotized at the second postoperative week. Surgeons should be cautious when using a reverse ALT flap to reconstruct a soft tissue defect located 10 cm or more distal from below the knee joint. Since a pedicle longer than 15 cm may develop partial necrosis of the flap, simultaneous application of antegrade venous drainage is recommended.

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