ABSTRACT
A 66-year-old woman had a recurrent desmoid tumor in the right thoracic apex. The tumor infiltrated the brachial plexus and eventually rendered the upper right extremity functionless. The tumor was removed by aggressive wide resection of the right upper hemithorax with simultaneous amputation of the functionless right arm. Reconstruction of the chest wall was accomplished, utilizing the soft tissues of the remnant arm as a pedicled flap to cover the full-thickness defect. Aggressive wide resection of the chest wall with limb amputation is technically challenging but unavoidable in some cases of recurrent desmoid tumor.
Subject(s)
Amputation, Surgical , Arm/surgery , Fibromatosis, Aggressive/surgery , Neoplasm Recurrence, Local/surgery , Thoracic Neoplasms/surgery , Aged , Brachial Plexus Neuropathies/complications , Brachial Plexus Neuropathies/surgery , Female , Fibromatosis, Aggressive/complications , Fibromatosis, Aggressive/pathology , Humans , Paralysis/etiology , Paralysis/surgery , Thoracic Neoplasms/complications , Thoracic Neoplasms/pathology , ThoracotomyABSTRACT
BACKGROUND: The epicanthal fold, which is peculiar to East Asians, forms an arch across the medial canthus in parallel with the nose. It is often accompanied by entropion of the medial eyelid. Although many surgical procedures have been described for correction of the epicanthal fold, none has reported a procedure to treat the epicanthal fold and entropion at the same time. The authors have performed a modified split V-W plasty to simultaneously correct entropion and to modify the epicanthal fold. METHODS: From January of 1998 to December of 2002, we have performed a modified split V-W plasty in 20 cases. The preoperative and postoperative medial canthal distances and palpebral fissure width were measured, and the extent of postoperative scarring and improvement of the epicanthal fold and entropion were reviewed. RESULTS: This method provided good results, including an inconspicuous scar, release of the epicanthal fold, and improvement of entropion. CONCLUSION: The authors believe that the modified split V-W plasty is available to eliminate entropion with an epicanthal fold in Asian eyelids.
Subject(s)
Blepharoplasty/methods , Entropion/surgery , Adolescent , Adult , Asian People , Child , Child, Preschool , Cicatrix/etiology , Eyelids/anatomy & histology , Female , Humans , Male , Postoperative Complications/etiology , Treatment OutcomeABSTRACT
We treated a patient with postlobectomy persistent alveolar fistula using a tissue expander, which is a prosthesis widely used in plastic surgery. The patient had thoracic empyema develop after right bilobectomy for lung cancer, and consequently underwent drainage of empyema followed by muscle flap closure for alveolar fistula. A residual space remained, and air leak persisted. However, implanting and expanding a tissue expander enabled us to tightly fix the flap on the raw pulmonary surface, which eventually solved the air leak. The tissue expander greatly contributed to muscle flap closure for a persistent alveolar-pleural fistula with a large remaining thoracic space.
