Prognostication of papillary thyroid microcarcinoma based on preoperative ultrasound.

Background: Diagnosis of papillary thyroid microcarcinoma, defined as papillary thyroid carcinoma measuring 1cm or less in greatest diameter, has increased with improvements in ultrasound technology and widespread familiarity and utilization. Given the indolent course of papillary thyroid carcinoma, active surveillance is considered an acceptable alternative to surgical resection for select patients. Candidacy for active surveillance is determined by a number of patient and tumor characteristics.

Advances in the diagnosis and treatment of ptosis.

Purpose Of Review: The surgical correction of blepharoptosis, both congenital and acquired, has been intensively examined and reported on for many years. This paper reviews recent publications on basic science, evaluation, technique modifications, and innovative materials in the care of ptosis patients.

Recent Findings: The frontalis suspension technique is a commonly performed surgical correction of congenital blepharoptosis, used widely in the repair of ptosis with poor levator function.

Efficacy of the pain pump catheter in immediate autologous breast reconstruction.

The purpose of the investigation was to evaluate the efficacy of a slow bupivacaine infusion at postoperative surgical sites in immediate breast reconstruction patients. This prospective study included 16 patients who underwent autologous breast reconstruction with a latissimus dorsi pedicled flap immediately after mastectomy. A two-site infusion kit with dual split-flow catheters was secured at the operative sites before skin closure.

The open preperitoneal approach to recurrent inguinal hernias in high-risk patients.

Background: Whether it is an open anterior, laparoscopic, or open preperitoneal approach, we have no general consensus on the preferred approach to recurrent inguinal hernia repairs. Recent reevaluations of the previously described open preperitoneal approach have shown promising results. We critically evaluate our experience with this procedure in our high-risk patient population and compare the results to other useful techniques.

Conjunctival melanoma metastasis diagnosed by sentinel lymph node biopsy.

Purpose: Evaluate the use of sentinel lymph node biopsy (SLNB) in staging and directing treatment of patients with conjunctival malignancy.

Design: Retrospective, noncomparative, interventional case reports.

Methods: Two patients with conjunctival melanoma underwent SLNB, which consisted of lymphoscintigraphy with injection of sulfur colloid technetium-99m.

Small incision transcutaneous levator aponeurotic repair for blepharoptosis.

Purpose: Patients presenting with blepharoptosis due to disinsertion or thinning of the levator aponeurosis require surgical repair. A minimally invasive approach directed specifically at the levator aponeurotic anatomic defect may provide benefits to the patient. Proposed advantages of a small eyelid incision (8-13 mm) include less local anesthetic and tissue distortion, less ecchymosis and edema, decreased operative times, a shortened recovery period, and improved surgical results.

Circumferential suction lipectomy of the trunk with anterior rectus fascia plication through a periumbilical incision: an alternative to conventional abdominoplasty.

During the past decade, many combinations of operative techniques for abdominoplasty have evolved to suit the individual requirements of the patient. The purpose of this study was to present a safe alternative to conventional abdominoplasty for appropriate patients, namely, those with minimal skin laxity, moderate fatty tissue distribution, musculofascial diastases, and no concern for abdominal stretch marks. The procedure consists of circumferential ultrasound-assisted liposuction and direct abdominal wall plication through a periumbilical incision.

Immunotherapy for melanoma metastatic to the orbit.

Purpose: To present 3 cases of melanoma metastatic to the orbit treated with various traditional modalities including surgery and chemotherapy and being treated with melanoma vaccines and to present background information on immunotherapy.

Methods: Retrospective review of 3 patients with melanoma metastatic to the orbit who were treated with melanoma vaccines along with conventional treatments. One patient had known orbital involvement before vaccine treatment; 2 patients had orbital metastases subsequent to vaccine administration.