Randomized trial of long-term effects of percutaneous tibial nerve stimulation on chronic pelvic pain.

Objective: To evaluate the long-term effects of percutaneous tibial nerve stimulation (PTNS) on quality of life in women with chronic pelvic pain.

Materials And Methods: Thirty-three women with chronic pelvic pain were randomized into PTNS (n = 16) or control (n = 17) groups. In PTNS group, weekly PTNS in 30-min sessions for 12 weeks was performed whereas the control group received no stimulation.

Nipple reconstruction with bipedicled dermal flap: a new and easy technique.

Background: Nipple reconstruction is the last step in breast reconstruction. An entirely satisfying breast reconstruction can be achieved only with a symmetrically placed and ideally shaped nipple-areola complex. Several techniques and modifications have been described for nipple-areola reconstruction but long-term projection loss is still a problem in nipple reconstruction.

Use of rapid prototyping in prosthetic auricular restoration.

Reconstructing auricular defects is a challenging task for facial reconstructive surgeons. Although autologous reconstruction is the first choice for reconstruction, there may be circumstances of inconvenience such as previously attempted surgery, radiotherapy, systemic conditions, or patient's wish. Auricular restorations with facial prosthesis have produced promising results, but there are still problems to be tackled for improved results.

Reconstruction of the urethral defects with autologous fascial tube graft in a rabbit model.

Aim: To investigate the feasibility of the autologous fascia graft in urethra defect reconstruction.

Methods: In 24 adult male rabbits, a standardized defect (17 mm) was created within the midportion of each urethra. Two-cm long fascial tube grafts were interposed between the cut ends of the urethra.

Midterm outcome after unilateral approach for bilateral decompression of lumbar spinal stenosis: 5-year prospective study.

The aim of our study is to evaluate the results and effectiveness of bilateral decompression via a unilateral approach in the treatment of degenerative lumbar spinal stenosis. We have conducted a prospective study to compare the midterm outcome of unilateral laminotomy with unilateral laminectomy. One hundred patients with 269 levels of lumbar stenosis without instability were randomized to two treatment groups: unilateral laminectomy (Group 1), and laminotomy (Group 2).

Reconstructing wide palatomaxillary defects using free flaps combining bare serratus anterior muscle fascia and scapular bone.

Purpose: Wide palatomaxillary defects, mostly after tumor resections, can cause severe functional and esthetic problems. Although prosthetic obturator devices or local flaps are mostly adequate for uncomplicated small-size defects, free flaps are preferred for a 3-dimensional multitissue reconstruction of more complicated defects. Regarding the anatomical structure of the palatomaxillary region, the flap must be thin enough to separate the oral and nasal cavities while not compromising palatal function, yet rigid enough for adequate dental restoration.

Effects of anterior contralateral cervical microdiskectomy on radiological and clinical outcome.

Background: We have conducted a prospective study to investigate the relationship between cervical spine alignment and clinical outcome in 102 patients undergoing anterior contralateral microdiskectomy without interbody graft or cage.

Methods: Preoperative and postoperative lateral cervical radiographs were obtained, and curvature of the surgically treated spinal segments and the overall curvature of the cervical spine were evaluated in all patients. Clinical outcomes were assessed using the NDI and SF-36.

Minimally invasive anterior contralateral approach for the treatment of cervical disc herniation.

Background: During the practice of ipsilateral approach to the offending lesion in anterior simple discectomy, the authors realized that it achieves better surgical exposure of the opposite foraminal area. In addition, it was also realized that routine procedures for better visualization of the foraminal area, such as stripping longus colli muscles, further excising of the anterior longitudinal ligament, or using a spreader, which cause more invasive surgery during the standard anterior approach, are not necessary because the contralateral approach already achieves sufficient exposure of the target foraminal area.

Objective: Evaluation of the results and effectiveness of this minimal invasive technique in patients with either soft or hard disc herniations.

Extended vertical trapezius myocutaneous flap in head and neck reconstruction as a salvage procedure.

In surgical treatment of head and neck cancer, when local tumor recurrence or failure of the previous reconstruction method occurs, reoperation for reconstruction of complicated soft-tissue defects can become a challenge for the plastic surgeon. This article describes the authors' experience with the extended vertical trapezius myocutaneous flap for head and neck complicated soft-tissue defects in nine patients ranging in age from 17 to 72 years. The causes of the defects were squamous cell carcinoma of the external ear (n = 2), lip (n = 2), larynx (n = 1), and oral cavity floor (n = 1); congenital hemifacial atrophy-temporomandibular joint ankylosis (n = 1); synovial sarcoma at the mandibular ramus (n = 1); and malignant fibrous histiocytoma at the posterior cranial fossa (n = 1).

Epithelialization process of free fascial flaps used in reconstruction of oral cavity mucosa defects in dogs.

Bare free fascial flaps are increasingly used for restoration of soft-tissue defects of the oral cavity because they provide thin, foldable tissues with high epithelialization capacity to preserve local anatomy as well as chewing, phonation, and deglutition. However, there are unanswered questions regarding the epithelialization process and other histopathologic changes occurring after transfer of these flaps into the oral cavity. To investigate these changes thoroughly, an experimental study was conducted in the dog model.

Modified transpedicular approach for the surgical treatment of severe thoracolumbar or lumbar burst fractures.

Background Context: Conventional transpedicular decompression of the neural canal requires a considerable amount of lamina, facet joint and pedicle resection. The authors assumed that it would be possible to remove the retropulsed bone fragment by carving the pedicle with a high-speed drill without destroying the vertebral elements contributing to spinal stabilization. In this way, surgical treatment of unstable burst fractures can be performed less invasively.

The use of sentinel lymph node biopsy in squamous cell carcinoma of the foot: a case report.

Squamous cell carcinoma (SCC) is the second most common skin cancer in humans. Because the incidence of metastasis from SCC of the skin is rare, regional lymphadenectomy is generally not recommended for the patients with clinically node-negative disease. However, in patients with an intermediate and high risk of metastasis, evaluation of the lymph nodes to detect the absence of metastatic nodal disease is a difficult task.

Removal of an anterior spinal dermoid cyst with fenestra corpectomy in Klippel-Feil syndrome: technical case report.

Objective And Importance: A spinal cord tumor occurring in association with Klippel-Feil syndrome is quite rare. The removal of an anteriorly located spinal cord tumor at the level of block vertebrae creates a surgical challenge.

Clinical Presentation: A case of an intradural extramedullary dermoid cyst located anterior to the spinal cord and a syringomyelic cavity at the level of block vertebrae in a 43-year-old woman with Klippel-Feil syndrome is presented.

Effects of vinblastine on healing in microvascular anastomosis.

Reconstructive microsurgical procedures are getting more common in cancer patients. Adjuvant therapies, such as chemotherapy, radiotherapy, and immune therapy, are usually combined with surgical approaches to improve outcomes. This study was designed to investigate the effects of preoperative chemotherapy on healing in microvascular anastomosis.

Bone induction capacity of the periosteum and neonatal dura in the setting of the rat zygomatic arch fracture model.

Objectives: Osteogenic properties of the dura and periosteum are thought to contribute to the regenerative capacity of membranous bone tissue. The purpose of this investigation was to elucidate (1) whether dura without underlying neural tissues can induce osteogenesis, (2) to what extent the periosteum participates in membranous bone healing, and (3) the difference between dura-induced and periosteum-induced osteogenesis.

Methods: A standardized 2-mm defect was created within the middle portion of each zygomatic arch in 30 Wistar albino rats.

Reconstruction of the replanted hand with latissimus dorsi muscle and serratus anterior fascia combined flap.

Reconstruction with the latissimus dorsi muscle flap, combined with the serratus anterior fascia flap, was performed to cover two large and separate palmar and dorsal forearm skin defects in a patient, whose hand had been replanted 20 days earlier after traumatic amputation at the distal forearm level. As a result, a total forearm amputation was salvaged by microsurgical replantation and a free combined flap of the subscapular system. This new application of the combined flap allowed the reconstruction of large and separate wounds of the replanted hand, and provided gliding surfaces for tendons.

The effects on prognosis of surgical treatment of hypertensive putaminal hematomas through transsylvian transinsular approach.

Objective: Hypertensive putaminal hematoma (HPH) is a devastating type of stroke that mostly results in death or severe neurologic deficit. There seems to be no general agreement on the selection of treatment modality for individual patients. In this study a comparison has been made between conservative treatment and the results of surgical treatment through the transsylvian transinsular approach of HPH with 30 cc or more.

Wide excision and free flap reconstruction of two cases with adult form of Juvenile Hyalin Fibromatosis localized on the foot.

Juvenile Hyalin Fibromatosis (JHF) or systemic hyalinosis is a rare, sporadic or hereditary disorder characterized by skin lesions, gingival hypertrophy, muscle weakness, and flexion contractures of large joints. There is still dispute in its pathogenesis and treatment. We described two cases with adult form of Juvenile Hyalin Fibromatosis localized in the foot and discussed the local control we achieved by surgery.

The sandwich technique for closure of a palatal fistula.

A full-thickness fistula of the hard palate can be closed by various methods. Recurrences are seen many times and more stable methods of closure have been researched. The authors attempted to close a palatal fistula by adhering to the main rule of reconstruction as stated by Gillies, "replace the lost tissues in kind.

Comparison between sensitive and nonsensitive free flaps in reconstruction of the heel and plantar area.

In this study, 12 cases of reconstruction of the heel and plantar area since 1982 are reviewed. Six nonsensate muscle free flaps and six sensate fasciocutaneous flaps were used, respectively. Categories assessed were the time interval for return to daily living activities, sensation to light touch, pinprick, Semmes-Weinstein monofilament test of the reconstructed area for sensory evaluation; and results of pedograms (maximal pressure, pressure distribution, and total contact area of the plantar surface).

Malignant fibrous histiocytoma developing in a burn scar.

Malignant fibrous histiocytoma (MFH) which is usually originated from muscles and deep fascia and rarely from the subcutaneous tissue is the most common soft tissue sarcoma; and it frequently invades the extremities. Occurrence of this tumor on a burn scar of scalp is a very rare entity. In the literature, there were only four reported malign fibrous histiocytoma cases that originated from a burn scar but none of them was at the scalp region.

Geometric limit of multiple local Limberg flaps: a flap design.

The Limberg rhombic flap is a reliable and widely used technique in head and neck surgery. Since Limberg introduced his original design in 1946, several modifications of the technique have been described. Although a single Limberg flap is frequently used at the face to close small to medium defects, multi-Limberg flap techniques can help the surgeon to cover moderate to large defects of the extremities, trunk, and back.

Mesenchymal hamartoma of the liver of an infant--case report.

A 10-month-old boy was found to have a huge hepatic mesenchymal hamartoma. Histologically the lesion appeared as large islands of loose mesenchymal tissue with profuse cystic bile ducts and hepatic cells. There were profuse bile duct and blood-vessel communications between the hamartoma and the right lobe of the liver.