Increasing Pedicle Reach with Musculocutaneous Perforator Dissection in Anterolateral Thigh Free Flaps.

Objective: To measure the increase in effective pedicle reach with microdissection of musculocutaneous perforators during anterolateral thigh (ALT) free tissue harvest.

Methods: A review of our institution's free flap database was performed to identify ALT free tissue transfers. The distance from pedicle vessel origin to its perforator's insertion at the fascia lata (effective pedicle length [EPL]) was measured prior to and following intramuscular dissection of musculocutaneous perforators.

Diagnosis and Management of Orbital Fat Exposure During Endoscopic Sinus Surgery.

Background: The orbital complication rate during endoscopic sinus surgery (ESS) is <1%. Orbital fat exposure during ESS can herald orbital complications including orbital hematoma, extraocular muscle trauma, optic nerve injury, or blindness. The objective of this study was to evaluate the current consensus regarding diagnosis and management of orbital fat exposure during ESS.

Advanced Techniques in Nonsurgical Rhinoplasty.

For a multitude of reasons, facial plastic surgeons should be adept and comfortable with nonsurgical rhinoplasty. An intimate knowledge of nasal vascular anatomy, filler choice, and proper placement can make this a safe, effective, and long-lasting treatment. Basic techniques include dorsal augmentation and camouflaging of a dorsal hump.

An update in facial gender confirming surgery.

Purpose Of Review: To summarize current surgical and nonsurgical approaches to facial gender confirming surgery (FGCS) and highlight standards of care and areas of future research.

Recent Findings: Gender nonconforming individuals may encounter considerable internal coping and external social stressors that may contribute to gender-associated dysphoria. FGCS provides patients the ability to align facial appearance with gender identity, using recently described advances in surgical and nonsurgical techniques.

Older siblings are at increased risk for foreign bodies.

A prospective, case-control study was performed to describe the role that siblings play in foreign bodies of the head and neck and to recognize situations in which children are most at risk for foreign bodies. Any child or adolescent (0 to 17 years old) with a foreign body removed from the head or neck was included. The data collected included location of the foreign body, location of acquisition (e.

Should all branch-duct intraductal papillary mucinous neoplasms be resected?

Background: The relationship between branch-duct intraductal papillary mucinous neoplasms (IPMNs) and malignancy remains controversial and difficult to assess.

Methods: Between January 1, 1999 and January 1, 2013, we identified 84 patients with IPMN who underwent resection.

Results: Preoperatively, 55 patients underwent endoscopic ultrasounds and 58 underwent biopsy.

The Association between Survival and the Pathologic Features of Periampullary Tumors Varies over Time.

Introduction. Several histopathologic features of periampullary tumors have been shown to be correlated with prognosis. We evaluated their association with mortality at multiple time points.

Bilateral urinary calculi with discordant stone composition.

Objectives: To describe a cohort of bilateral stone formers with significantly different compositions between renal units.

Methods: Patients treated for bilateral nephrolithiasis over a 4-year period (2007-2010) were identified. Stones were categorized by dominant (≥50%) mineralogical component.

Comparison of complication rates for unilateral and bilateral percutaneous nephrolithotomy (PCNL) using a modified Clavien grading system.

Objective: To compare complication rates of unilateral vs bilateral percutaneous nephrolithotomy (PCNL) using the modified Clavien grading system.

Patients And Methods: Single-institution retrospective chart review. Identified patients who had synchronous bilateral PCNL (B-PCNL) over an 11-year period (2000-2011).

Metabolic syndrome and urinary stone composition: what factors matter most?

Objective: To determine which metabolic syndrome (MetS) factors lead to differences in stone composition in a multivariate analysis.

Methods: We retrospectively reviewed medical charts of patients who had a kidney stone removed over a 5-year period (2006-2011). MetS factors (obesity [body mass index {BMI} >30], diabetes mellitus [DM], hypertension [HTN], and dyslipidemia [DLD]) were tallied in each patient.

Effect of renal function on urinary mineral excretion and stone composition.

Objective: To determine the effect of renal function on urinary mineral stone excretion and composition of kidney stones in patients undergoing urologic intervention for nephrolithiasis.

Methods: We performed a retrospective analysis of 158 patients with 193 kidney stones who underwent endourologic intervention for nephrolithiasis. The patients were grouped by the estimated glomerular filtration rate (eGFR).