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Our Editor-in-Chief Dr. Holger Sudhoff and Deputy Editor Dr. Chin-Lung Kuo of AOHNS were recognized in the list of the World's Top 2% Scientists published by the prestigious Stanford University. The SciTeMed Publishing group would like to congratulate Dr. Holger Sudhoff and Dr. Chin-Lung Kuo for this honor that has brought great pride to our publisher.
There have been several developments in the management of epistaxis. In this article, the author has reviewed the literature on epistaxis, its anatomy, etiology, and the current developments in its treatment. The stepwise treatment algorithms and flow diagram provided in the article will guide the clinicians to produce better results in epistaxis management.
Tracheomalacia is a rare congenital abnormality of the tracheobronchial cartilage causing the collapse of the airway and obstruction of expiratory flow. It is very difficult to manage infants with severe tracheomalacia. Severe cases lead to worse respiratory conditions and may become life-threatening, and necessitate immediate surgical treatment. Takeshi Yano of the University of Miyazaki, Japan has published an article in the Annals of Case Reports and Images Journal, in which a method to manage severe tracheomalacia patients using muscle relaxant has been discussed.
The study by Dr. Chin-Lung Kuo provided strong evidence, which was unrecognized earlier, to establish the potential link between cholesteatoma and depression. It is necessary to conduct routine psychiatric screening and monitoring of cholesteatoma patients for detection and treatment at the beginning stage itself. Despite the accuracy and acceptability of this population-based study, more prospective studies need to be carried out for additional confirmation.
The Institute of Safe Medication Practices has listed Oxytocin and Magnesium sulfate as high-alert medications causing significant harm to patients when used in error. Since these medications are frequently used in Labor & Delivery (L&D) units, safe administration to prevent medication errors is necessary for these units. As a part of the Safety Program for Perinatal Care (SPPC) of the Agency for Healthcare Research and Quality (AHRQ), several L&D units opted for implementing safety science principles for the safe administration of oxytocin and magnesium sulfate. The research team led by Kayla B Gray has published a qualitative research article in the Research on Women’s Health Journal, which describes the experiences of 25 L&D units, which have opted to implement the safety science principles for the safe administration of these medications.
Dr. Shyun-Jing Wee, the author of the article, entitled Penopubic Junction Reconstruction Using a Pedicled Superficial Circumflex Iliac Artery Perforator Flap, met with the editors at SciTeMed as well as expert mentors to discuss the research in order to maximize its impact and ensure its wide dissemination. The webinar was moderated by Dr. Laura Chia-Fang Chen, a surgeon at Linkou Chang Gung Memorial Hospital who specializes in plastic and reconstructive surgery.
Here is a video that shows the harvest of a thin profunda artery perforator flap from the left thigh. In conjunction with preoperative computed tomography angiography, measurement of the morphology of the perforators and their branches, the pedicle length, and the vertical locations of the two branches from the ischial tuberosity are performed. A handheld doppler is used to confirm the location of both branches. As a result of the authors' results, preoperative computed tomography angiography is a valuable way of obtaining detailed anatomical information such as the shape of perforators, their path through the septum or muscle above the deep fascia, as well as the thickness of the skin. It is important to know that computed tomographic angiography is an excellent means of making an assessment of the entire vascular anatomy of the leg, and it results in making an informed decision about the choice of flaps, based on the patient's anatomy and the characteristics of the defect.
Vertical sleeve gastrectomy (VSG) is a type of bariatric surgery that is accepted as the simplest but most efficient surgical modality to treat morbid obesity. A mouse model of VSG has been widely utilized to investigate the underlying mechanisms of VSG. There are numerous microsurgical techniques for VSG in mice, and the authors report herein a modified technique with 2 disposable micro-clamps to simplify the surgery. The key aspects of the modification are to use the micro-clamps as non-crushing tissue clamps for anastomosis as well as vascular clamps for hemostasis. Mean body weight at postoperative week 1 was 24.1 grams, which is equivalent to a 16.1% loss of original body weight, and there was no mortality after antrum preservation VSG. This simplified surgical technique will best serve as a tool to investigate either the underlying mechanisms of VSG or the intrinsic change to the stomach after VSG.
One of the aims of several reconstructive surgical procedures is to achieve a patent microvascular anastomosis. Developing clinical competency in this specialized skill requires intensive training on live animal models as a first step. The early training stage of microvascular anastomosis can be stressful for novices. This is because the rat vessels used in such training courses are usually too small and fragile for novices to maintain the vascular lumen in an optimal fashion. Throughout this paper, the authors discuss the use of a silicone tube to provide structural support to vessels throughout the entire precarious suturing process. Using this modified version of the conventional microvascular anastomosis technique may facilitate initial skill acquisition in the rat model.
Lymphaticovenular anastomosis (LVA) and vascularized lymph node transfer (VLNT) are established lymphedema treatments. However, LVA is only effective for early disease and VLNT can cause donor-site lymphedema and contour deformity. Vascularized lymph vessel transfer (VLVT) is free of these limitations. In the video, the authors described their experience of a new VLVT technique.
This video shows a laryngoscopic examination for signs of laryngeal irritation associated with laryngopharyngeal reflux. Large bilateral granulomas are identified on the surface of bilateral arytenoids
The incidence of Head and Neck Juxtacortical Chondrosarcoma (HNJCS) is extremely rare. Among a large database, the authors could identify only nine cases of HNJCS that have been amply described. It has been observed that irrespective of the location of the body, HNJCS has a consistent clinical and diagnostic profile. HNJCS is generally a low or intermediate grade malignancy with a low rate of recurrence and metastases. Primary surgical excision with negative margins was found to be the therapeutic modality of choice. Radiotherapy and chemotherapy have limited roles in the management of HNJCS.
In this article, the author reviews the manifestations, diagnosis, and treatments of LPR and suggests adopting a multidisciplinary approach for a reliable and conclusive diagnosis of LPR. Based on the previous research and latest findings, an algorithm is put forth to streamline the assessment and management of reflux disorders. Highlighting the significance of correct diagnosis and effective treatment of LPR, the author suggests that in case the diagnosis is doubtful, and the therapeutic response is unsatisfactory, the patient should be referred to a specialist.
Based on the comparison between the hematology and cytology, the authors concluded that by improving the skills of the technologists of the hematology laboratory in identifying cell morphology, the diagnostic values in body fluid malignancy could be improved, and the hematology laboratory would achieve comparable competency similar to the cytology laboratory.
Procedure-related miscarriage is the most crucial complication of the prenatal invasive tests which are being used for the diagnosis of fetal aneuploidies. Even though several risk factors like operator experience, gestational age, sampling route, and the number of tapping have been suggested for the procedure-related miscarriage, the cause of this complication remains unknown. The results of the study confirmed that the cervical lengths in the patients complicated with miscarriages were within normal limits.
The brain can process information, store them, and retrieve them as and when required; however, we hardly know much about the physiological mechanisms behind such fundamental functions of the brain. The efforts by psychologists, scientists, engineers, physicists, and mathematicians over the past decades have given some significant insight on the brain functions and have been helpful for carrying out further research on the subject.
It is our pleasure to invite Prof. Isao Koushima to be Editor-in-Chief in International Microsurgery Journal!
Over the past decade, Da Vinci Surgical System has made great strides in surgery. It has been widely applied in urology, gynecology, bariatric surgery, hepatobiliary surgery, thoracoscopic surgery, cardiac surgery, neurological surgery, and transoral otolaryngologic neoplasm resection. However, its application in plastic and reconstructive surgery still in the preliminary stages of development. I went to Hong Kong in April 2013 for the robotic surgical system training program and was awarded console surgeon certificate.
This novel technique of sequential ETS micro-venous anastomosis is a modified technique from its classical form. The unique use of vessel loops provides protection to the vessel, while it achieves equisegmental IJV occlusion for sequential (proximal to distal) venous anastomosis. This method not only saves precious operating time from repetitive positioning of instruments and recipient vessel (IJV), but also creates a safer operating field for the microsurgeons. Utilizing a second single vascular clamp over the anastomosis junction provides an anchoring point for self-retraction by revealing and maintaining an accessible position to the posterior wall, once it is turned at 180 degrees laterally. This maneuver allows the surgeon to have full control of the surgical field and perform ETS micro-venous anastomosis confidently and independently.
Division of the lateral plantar artery does not jeopardize the foot circulation because of anastomosis of the lateral plantar artery with the dorsalis pedis artery at the first intermetatarsal space. However, care should be taken with patients with peripheral artery occlusive disease and the flow of dorsalis pedis artery should be confirmed before surgery. Given the advantages of sizable vessel, easy dissection, and proximity to the defect, we believe that the lateral plantar artery might be a valuable option as recipient vessel for lateral plantar forefoot reconstruction.
Pedicled anterolateral thigh flap is a versatile option for reconstruction of complex soft tissue defects in varied anatomical regions. Its wide arc of rotation and less donor site morbidity are its added advantages.
The 2nd instructional course for adult brachial plexus injuries is a fantastic opportunity to meet and learn from experts in the field. We cordially invite you to visit Chang Gung Memorial Hospital to participate in this unique learning experience.