Background: Sternal tumors are rare, comprising only 0.94% of all bone tumors, with the majority being sarcomas. An extensive composite defect is often the result of surgical resection. Reconstruction of this anatomical area is a challenge for plastic surgeons. Reconstruction must fulfil two different tasks: restoration of soft tissues and stabilization of the chest wall. Both are well defined, and many techniques have been historically proposed.
Methods: We present the case of a 66-year-old man affected by sternal metastasis of lung non-small cell carcinoma with sarcomatoid features. After wide tumor resection, a large defect was created.
Results: The patient underwent a complex multilayer reconstruction that combined multiple techniques: Gore DualMesh to reconstruct the pericardial plane and protect the heart muscle, omental flap to facilitate integration of the mesh, titanium bars to recreate chest wall stability, and bilateral pectoralis muscle flaps to cover hardware. This multilayer reconstruction was named the "lasagna technique."
Conclusions: Due to the rarity of primary malignancies of the sternum, it is difficult to standardize a therapeutic approach. For this reason, it is necessary to customize the surgical treatment by combining several techniques and materials. Our lasagna technique may be considered a valuable option in treating these complex reconstructive cases.
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http://dx.doi.org/10.1097/GOX.0000000000005384 | DOI Listing |
Introduction: Solitary plasmacytomas are tumors characterized by a local increase of malignant plasma cells in soft tissue or bone and may occur anywhere without evidence of systemic disease. The aim was to focus on the main surgical techniques and outcomes for this rare chest wall tumor.
Methods: Patients with solitary plasmacytoma involving a rib, who were operated for diagnostic or treatment purposes between 2018 and 2023 were retrospectively reviewed.
Eur J Trauma Emerg Surg
January 2025
Department of Intensive Care Medicine and Intermediate Care Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, D-52074, Aachen, Germany.
Purpose: Osteosynthesis seems to have effects regarding clinical outcomes in trauma patients. However, current knowledge on chest wall osteosynthesis in polytrauma patients is insufficient, leaving its potential unanswered. Therefore, the objective of this systematic review is to assess the safety and effects of chest wall osteosynthesis compared to conservative treatment on clinical outcomes in adult polytrauma patients.
View Article and Find Full Text PDFJ Neurophysiol
February 2025
Breathing Research and Therapeutics Center, Department of Physical Therapy, University of Florida, Gainesville, Florida, United States.
We present a case report of a 42-year-old female with post-West Nile virus meningoencephalitis who exhibited unique, long-latency diaphragm potentials evoked by transcranial and cervical magnetic stimulation after exposure to acute intermittent hypoxia (AIH). The subject was recruited for a study investigating AIH effects on respiratory motor function in healthy individuals. She had contracted West Nile virus infection 5 years before assessment that resulted in hospitalization and persistent allodynia but was not reported to the research team.
View Article and Find Full Text PDFJ Surg Case Rep
January 2025
Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), 1000 rue St-Denis, Montreal, QC H2X 0C1, Canada.
Intervertebral thoracic disk herniation (TDH) is a rare occurrence and presents with a wide variety of symptoms. Errors in diagnosis are thought to be frequent due to the variable clinical presentations. We herein present two unusual cases of TDH presenting with abdominal pseudohernias, abdominal pain, and hypoesthesia along the T11-T12 dermatomes due to TDH at the same level.
View Article and Find Full Text PDFBrain Spine
December 2024
Department of Neurosurgery, Johann Wolfgang Goethe University Hospital, Frankfurt, Germany.
Introduction: Breathing-synchronized hypoglossal-nerve stimulation is a treatment option for suitable patients with severe obstructive-sleep-apnoea. The classical implantation technique requires three incisions: submental to place the stimulating-electrode on terminal branches of the hypoglossal-nerve, sub-clavicular to place the impulse generator, and on the lateral chest-wall to place a breathing-sensor lead. A two-incision-technique has been propagated and widely adopted whereby the respiratory-sensing-lead is placed deeper to the IPG-pocket.
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