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International Microsurgery Journal

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Reconstruction of Massive Chest Wall Defect After Bilateral Mastectomy Using a Bipedicled Deep Inferior Epigastric Perforator Flap: A Case Report

This case highlights the use of a bipedicled deep inferior epigastric perforator (DIEP) flap for reconstructing a massive 45 × 17 cm chest wall defect following bilateral mastectomy. By preserving abdominal musculature and utilizing preoperative computed tomographic angiography (CTA) for perforator mapping, the technique enabled tension-free bilateral microvascular anastomosis to the internal mammary arteries. The incorporation of submuscular mesh and minimal donor-site undermining maintained abdominal wall integrity. At six-month follow-up, no hernia or functional deficits were observed, and the patient reported high satisfaction on the BREAST-Q. This muscle-sparing strategy offers a viable alternative for large, midline-crossing chest wall defects where conventional flaps may be insufficient.

2025/07/01

$Microsurgical Lymphatic Reconstruction for Refractory Chylous Ascites in Systemic Lupus Erythematosus: Case Report and Literature Review$

Microsurgical Lymphatic Reconstruction for Refractory Chylous Ascites in Systemic Lupus Erythematosus: Case Report and Literature Review

This article presents the first comprehensive review of refractory chylous ascites associated with systemic lupus erythematosus, analyzing 19 cases to propose an evidence-based therapeutic framework. It introduces lymphatic bypass surgery as an effective option for this rare complication, overcoming the limitations of conventional treatment. By integrating mechanical drainage, immunomodulation, and lymphangiogenesis, this approach achieves rapid and sustained resolution of ascites. The findings offer a novel surgical strategy for autoimmune lymphatic disorders and prompt a re-evaluation of their complex pathophysiology. This study demonstrates how surgical innovation can succeed where traditional therapies fail, offering new hope in managing refractory autoimmune disease.

2025/06/11

NSD3::NUTM1 Fusion in Primary Parotid NUT Carcinoma: First Report and Comprehensive Literature Review

This report presents the first documented case of parotid NUT carcinoma with an NSD3::NUTM1 fusion, characterized by rapid metastasis and patient death five weeks post-surgery. This outcome challenges prior reports suggesting favorable survival for non-thoracic NSD3::NUTM1 tumors, indicating potential parotid-specific aggression. By integrating 13 previously published cases with the current case, the article provides a comprehensive clinicopathological reference for this rare malignancy. While further validation is required, the findings advocate for targeted NUT immunohistochemistry and molecular profiling in undifferentiated parotid tumors. BET inhibitors show therapeutic potential, underscoring the need for early recognition and precision-based care.

2025/05/19

Drainless Versus Drain-Based DIEP Flap Breast Reconstruction: A Systematic Review and Meta-Analysis of Postoperative Complications

This systematic review and meta-analysis provide a pragmatic evaluation of drain-free versus drain-based DIEP flap techniques for breast reconstruction, challenging the traditional reliance on drainage. By analyzing postoperative outcomes, the study highlights the potential for refining surgical strategies to enhance patient comfort and recovery without compromising safety. The findings offer a neutral perspective, suggesting that clinical practice may not necessarily depend on the use of drains. This revelation prompts medical professionals to reassess existing surgical approaches and may catalyze a paradigm shift in postoperative care. Presented with clear narrative and rigorous data analysis, the article encourages readers to consider the broader implications of surgical innovations on patient care protocols.

2025/04/21

Optimizing Dysphagia Management in Head and Neck Cancer Radiotherapy: Advanced Imaging, Precision Dosimetry, and Rehabilitation

This narrative review advances the management of radiation-induced dysphagia in head and neck cancer treatment by integrating advanced imaging, precision dosimetry, and structured rehabilitation. Beyond focusing solely on dysphagia-optimized intensity-modulated radiotherapy, it explores a variety of approaches: MRI and CT provide detailed anatomical insights, while proton therapy offers a less toxic alternative, and early rehabilitation preserves swallowing function. This holistic model prioritizes patient quality of life, detailing how techniques like Do-IMRT reduce radiation to critical structures like the pharyngeal constrictors and larynx, maintaining effectiveness. The review advocates a multidisciplinary approach, encouraging collaboration among oncologists, radiologists, and therapists to enhance long-term patient well-being and promoting further research to elevate care standards.

2025/04/03

An ENT Physician’s Unexpected Encounter: Insights into Academic Stress Through a Clinical Case

This editorial analyzes the extensive social and familial effects of rigorous educational demands in Taiwan, illustrated by a case study of a 45-year-old female music teacher with sudden sensorineural hearing loss. Forced to skip her medical appointments due to her child's demanding academic schedule, the incident highlights the profound impact of intense educational routines on family life. It critiques the prioritization of academic achievement over well-being, which places undue stress on both children and parents, advocating for a reevaluation of the emphasis on scholastic success versus holistic development. The piece calls for educational reforms towards nurturing, developmentally appropriate strategies that support natural growth and foster a lifelong love for learning. It promotes innovative teaching approaches, early intervention, and strategic use of educational technology to enhance learning outcomes, urging systemic changes to better prepare students for today's complex world. Overall, this is a commendable editorial that offers valuable insights into the need for educational reform.

2024/12/27

SciTeMed Waives Article Processing Charges for 3 Months – Supporting Open Research and Scientific Advancement

At SciTeMed, we're committed to promoting the global sharing of high-quality medical research. To further our mission and reduce barriers for researchers, we're excited to announce a special 3-month waiver of our standard Article Processing Charges, normally $790 USD per article, generously supported by our partnering organizations and academic foundations. We aim to encourage more researchers to share their innovative findings and valuable clinical experiences with the international community. By waiving these fees, we hope to support open access to critical medical research, helping to drive forward scientific discovery and improve patient care worldwide.

2025/03/28

Celebrating Seven Years of Collaboration: Special APC Waiver for Original Research Submissions to IMJ

We are excited to announce a special opportunity for researchers in celebration of our seven-year collaboration with the International Microsurgery Club. The International Microsurgery Journal (IMJ) is pleased to offer a full waiver of the USD 790 article processing charge (APC) for original research articles submitted from now until the end of August. This initiative underscores our commitment to supporting the scientific community by ensuring that groundbreaking research in the field of microsurgery is accessible and widely disseminated. By publishing with IMJ, authors benefit from a rigorous peer-review process, rapid publication timeline, and extensive visibility. Importantly, authors retain full copyright ownership of their work, allowing for complete control over its use and distribution. Researchers are encouraged to take advantage of this exclusive offer by submitting their manuscripts via our submission portal by August 31. For submission details and inquiries, please visit our submission portal at IMJ Submission Portal or contact us at contact@scitemed.com. We look forward to receiving your valuable contributions and continuing to advance the field of microsurgery together.

2024/08/04

Full Publication Fee Waiver for Submissions to the International Microsurgery Journal Prior to November 30, 2023

As we approach the seven-year milestone of our alliance with the International Microsurgery Club, we are delighted to extend a gesture of appreciation by offering a waiver of the usual publication fee of USD 790 for submissions of all article types to the International Microsurgery Journal. This waiver is a testament to our sustained partnership and our commitment to advancing the field of microsurgery. Kindly be aware that this special promotion will end on November 30, 2023. We encourage our respected contributors to seize this exclusive offer.

2023/11/04

World's Top 2% Scientists in AOHNS

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.

2021/12/09

A Full Waiver of Any Submission of Original or Review Article to International Microsurgery Journal (IMJ) from Sep. 4, 2021 to Oct. 31, 2018!

To celebrate nearly 5 years of partnership with International Microsurgery Club, we are waiving the publication fee (USD 790) for any submission of original article or review article to International Microsurgery Journal. This offer ends on Oct. 31, 2021. Join us today!

2021/09/04

Effective Management of Epistaxis

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.

2021/04/25

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Conversations with SciTeMed Editors and Expert Mentors

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.

2022/08/18

Design and Harvest of the Thin Profunda Artery Perforator Flap

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.

2021/10/01

A Modified Technique of Mouse Vertical Sleeve Gastrectomy Using Two Disposable Micro-clamps

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.

2020/09/24

An Innovative Method for the Training of Microsurgical Anastomosis Using a Silicone Tube

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.

2020/01/21

Vascularized Lymph Vessel Transfer - Lymph Node Transfer 2.0?

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.

2019/10/31

Laryngoscopic Examination for Signs of Laryngeal Irritation Associated With Reflux

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

2019/01/09

Editor's Choice

Articles

News

Videos

Cranial Nerve Schwannomatosis: A Case Report and Comprehensive Literature Review on a Distinct Variant of Neurofibromatosis

This article presents a comprehensive review of schwannomatosis affecting cranial nerves, delineating its unique characteristics distinct from other forms of neurofibromatosis. By addressing diagnostic complexities and the evolving criteria for identification, the paper emphasizes the critical need for accurate recognition of schwannomatosis to facilitate effective management and provide essential genetic counseling. Enriched with a detailed case study, this review delivers vital insights into the epidemiology, symptomatology, and therapeutic strategies for schwannomatosis, advocating for a revision in current clinical approaches. This work is indispensable for medical professionals aiming to enhance diagnostic precision, comprehend genetic underpinnings, and improve patient outcomes. Offering a thorough analysis of this rare condition, the article is pivotal not only for clinicians and researchers in the neurogenetic field but also for a broader spectrum of medical and scientific communities, bridging a notable gap in contemporary medical literature.

2024/05/20

Chimeric Radial Forearm Flap With Pronator Quadratus Muscle for Facial Reanimation: An Anatomical Feasibility Study

This article presents a groundbreaking surgical approach for treating facial paralysis, focusing on the combination of the pronator quadratus muscle (PQM) and the radial forearm flap (RFF). It addresses the challenges in restoring facial functions and skin closure in paralysis cases. The study's novelty lies in its detailed examination of the PQM's vascular anatomy when combined with the RFF, a topic previously unexplored. Through meticulous dissections, it provides crucial anatomical insights essential for enhancing facial reanimation surgeries, offering significant benefits in medical practices related to facial reconstruction and nerve transfer techniques.

2023/11/23

Redefining Fasciocutaneous Microanatomy: An Illustrated Review of Current Concepts and Their Clinical Correlates

This comprehensive review article presents a profound exploration of critical facets within the realm of microsurgery, challenging existing paradigms. Through meticulous examination, the authors illuminate the intricate world of microangiosomes, dissection planes, and the clinical relevance of anatomical structures. Central to this discourse is an exhaustive comparative analysis of dermal plexus flaps, meticulously dissecting the viability and potential grafting applications of subdermal versus deep-dermal plexi. Augmenting this intellectual voyage are detailed illustrations, guiding readers through the intricate microanatomy underlying skin and adjacent tissues. This synthesis of knowledge not only redefines existing microsurgical principles but also opens new frontiers. By unearthing novel perspectives on microangiosomes and dissection planes and by offering a comparative insight into dermal plexus flaps, this work reshapes the landscape of microsurgery. These elucidations, coupled with visual aids, equip practitioners with invaluable insights for practical integration, promising to propel the field of microsurgery to unprecedented heights.

2023/09/14

Peer Review for Academic Research

This article provides an overview of the major elements of a comprehensive manuscript review. The article also illustrates some of the basic responsibilities of the reviewer and describes some of the benefits and burdens associated with this role. Scholars may find this article useful as they conduct critical reviews of research papers.

2022/01/20

Development of Tibial Osseo-Periosteal Flap for Complex Nonunions and Bone Defects

The senior author (Dr. Isao Koshima) designed a tibial osseo-periosteal (TOP) flap. TOP flap has a favorable anatomical position with a thin skin around it, hence it is a good option for an island flap. TOP flap can be used for various mild to moderately sized osteo-cutaneous defects with low morbidity. In this article, the authors describe their experience of the first reported cohort of TOP flaps in clinical practice.

2021/12/03

Illness Perceptions, Psychological Distress and Coping Strategies as Predictors of Quality of Life After Radiotherapy in Head and Neck Cancer Patients

The study aims to assess the predictive values of certain psychological factors on the quality of life in patients with Head and Neck Cancer after radiotherapy. The authors conclude that the identification and the understanding of the depressive symptoms of patients, their beliefs about their illness as well as their coping strategies may provide the basis for timely implementation of appropriate intervention that may improve the quality of life in patients.

2021/07/05

Head and Neck Juxtacortical Chondrosarcoma

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.

2021/04/19

Assessment and Management of Laryngopharyngeal Reflux

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.

2020/11/26

A Comparison of Hematology and Cytology Laboratories in Detection of Body Fluid Malignancy

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.

2020/05/20

Can the Cervical Length Predict Procedure-Related Miscarriage?

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.

2019/12/23

The Brain Functions Mathematically!

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.

2019/02/18

Welcome Prof. Isao Koushima as Honorary Editor-in-Chief in International Microsurgery Journal

It is our pleasure to invite Prof. Isao Koushima to be Editor-in-Chief in International Microsurgery Journal!

2018/04/15

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Experience with Robotic-assisted Microsurgery

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.

2017/10/28

Chang's Technique of Sequential End-to-Side Microvascular Anastomosis

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.

2017/10/28

Lateral Plantar Artery as Recipient Vessel for Microsurgical Lateral Plantar Forefoot Reconstruction

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.

2017/10/28

The Versatility of Pedicled Anterolateral Thigh Flap - A Tertiary Re-ferral Center Experience from India

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.

2017/10/28

A Great Opportunity to Meet and Learn from Peripheral Nerve Experts

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.

2017/10/27

Interview with Dr. Murray Grossan, the Honorary Editor-in-Chief of AOHNS

An exciting conversation with Dr. Murray Grossan, the Honorary Editor-in-Chief of Archives of Otorhinolaryngology-Head & Neck Surgery (AOHNS). Dr. Murray Grossan talked about AOHNS’s new direction and the important means for communicating scientific work to complement teaching and training in the field of medicine.

2017/07/25