Background: To restore breast sensibility, some centers are offering nerve reconstruction as a component of implant and flap-based breast reconstruction. To interpret and contextualize the results of these procedures, it is necessary to understand the normal range of breast sensibility, the factors that affect it, and the best methods for its objective measurement.
Methods: We conducted systematic and comprehensive searches across PubMed, Web of Science, and Cochrane Library databases using keywords and controlled vocabulary for the concepts of the breast, nipple, areola, and measurement.
Spinal accessory nerve (SAN) palsy is typically a result of posterior triangle surgery and can present with partial or complete paralysis of the trapezius muscle and severe shoulder dysfunction. We share an atypical case of a patient who presented with SAN palsy following an injury sustained playing competitive volleyball. A 19-year-old right hand dominant competitive volleyball player presented with right shoulder weakness, dyskinesia, and pain.
View Article and Find Full Text PDFSomatic manifestations of mental illness sometimes occur in patients presenting to hand specialists. These conversion disorders can also occur in groups, a phenomenon known as "mass psychogenic illness." The increasing penetrance of the Internet and social media in modern society has greatly facilitated the interaction of patients with others with similar disorders.
View Article and Find Full Text PDFPainful neuromas result from traumatic injuries of the hand and digits and cause substantial physical disability, psychological distress, and decreased quality of life among affected patients. The regenerative peripheral nerve interface (RPNI) is a novel surgical technique that involves implanting the divided end of a peripheral nerve into a free muscle graft for the purposes of mitigating neuroma formation and facilitating prosthetic limb control. The RPNI is effective in treating and preventing neuroma pain in major extremity amputations.
View Article and Find Full Text PDFSuccessfully and efficiently bridging peripheral nerve gaps without the use of autografts is a substantial clinical advance for peripheral nerve reconstructions. Novel templating methods for the fabrication of conductive hydrogel guidance channels for axonal regeneration are designed and developed. PEDOT is electrodeposited inside the lumen to create fully coated-PEDOT agarose conduits and partially coated-PEDOT agarose conduits.
View Article and Find Full Text PDFBackground: The authors' goal is to develop a peripheral nerve electrode with long-term stability and fidelity for use in nerve/machine interfaces. Microelectromechanical systems use silicon probes that contain multichannel actuators, sensors, and electronics. The authors tested the null hypothesis that implantation of microelectromechanical systems probes does not have a detrimental effect on peripheral nerve function or regeneration.
View Article and Find Full Text PDFBackground: Microsurgical perforator flaps are useful in an array of reconstructive scenarios, but their technical complexity, steep learning curves, and prolonged operative times may limit their widespread adoption. Alternatively, the keystone island flap combines perforator-based vascularity with relative simplicity of nonmicrosurgical tissue rearrangement. This article reviews the authors' reconstructive experience using the keystone flap to reconstruct large trunk and extremity defects.
View Article and Find Full Text PDFBackground: Bionic limbs require sensitive, durable, and physiologically relevant bidirectional control interfaces. Modern central nervous system interfacing is high risk, low fidelity, and failure prone. Peripheral nervous system interfaces will mitigate this risk and increase fidelity by greatly simplifying signal interpretation and delivery.
View Article and Find Full Text PDFJ Pediatr Ophthalmol Strabismus
August 2013
Purpose: To determine the frequency and distribution of horizontal misalignment in patients with unilateral superior oblique palsy (SOP) and to determine the indications for combining horizontal with vertical strabismus surgery.
Methods: Patients included in the study had a vertical heterophoria or tropia that fit Parks three-step test for SOP and had no previous strabismus surgery or other ocular motility disturbance. Ocular motility and alignment were recorded.
Despite significant burn treatment advances, modern multidisciplinary care, and improved survival after burns, facial burn scars remain clinically challenging. Achieving a successful reconstruction requires a comprehensive approach, entailing many advanced techniques with an emphasis on preserving function and balancing intricate aesthetic requirements. Pediatric facial burns present the same reconstructive challenges seen in adults, with additional developmental and psychologic concerns.
View Article and Find Full Text PDFPlastic surgeons are frequently faced with difficult and challenging soft tissue defects in all areas of the body. To reconstruct these defects, there are many operative approaches available to the reconstructive surgeon including skin grafts, local flaps, regional flaps, and free-tissue transfer. Despite these many options, occasionally the best alternative for reconstruction of a wound is tissue expansion, where skin of similar quality, texture, and color can be used to close a soft tissue defect.
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