ABSTRACT
Scaphocephaly is the commonest form of craniosynostosis with a varied presentation consisting of many morphological components and a range of possible surgical interventions. However, with regard to esthetic assessment, there is no universally applied assessment system. The aim was to develop a simple assessment tool encompassing multiple phenotypic components of scaphocephaly. This was done by piloting a red/amber/green (RAG) scoring system to judge esthetic outcomes following scaphocephaly surgery using photographs and experienced observers. Standard photographic views of 20 patients who had undergone either passive or anterior 2/3 vault remodelling were scored by 5 experienced assessors. Using a RAG scoring system before and after scaphocephaly correction according to 6 morphological characteristics: visual impression of cephalic index, calvarial height, bitemporal pinching, frontal bossing, posterior bullet, and displacement of the vertex. All 5 assessors were asked to score the preoperative and postoperative views independently. The RAG scores were each assigned a number (1-3) and added to give a composite score (range 6-18) and these were averaged between the 5 assessors. There was a highly statistically significant difference between both preoperative and postoperative composite scores ( P <0.0001). A subgroup analysis of the postoperative composite score between the 2 surgical techniques showed no significant difference ( P =0.759). The RAG scoring system can be used to assess esthetic change following scaphocephaly correction and it provides both a visual analogue and a numerical indicator of change. This assessment method needs further validation but is a potentially reproducible way to score and compare esthetic outcomes in scaphocephaly correction.
Subject(s)
Craniosynostoses , Plastic Surgery Procedures , Humans , Infant , Pilot Projects , Esthetics, Dental , Craniosynostoses/surgery , Head/surgery , Retrospective Studies , Skull/surgerySubject(s)
Carcinoma, Basal Cell/complications , Carcinoma, Basal Cell/surgery , Lymphatic Metastasis/drug therapy , Lymphatic Metastasis/physiopathology , Lymphatic Metastasis/radiotherapy , Rare Diseases/drug therapy , Skin Neoplasms/complications , Skin Neoplasms/surgery , Aged, 80 and over , Carcinoma, Basal Cell/diagnosis , Humans , Lymphatic Metastasis/diagnosis , Male , Rare Diseases/diagnosis , Rare Diseases/physiopathology , Skin Neoplasms/diagnosis , Treatment OutcomeABSTRACT
We present a report of an anatomical variation, the function of which is unclear. An anomalous, independent tendon to the thumb was accompanied by an accessory supernumerary tendon to the extensor indicis. This particular variation has not previously been described and was discovered during routine dissection of a male cadaveric upper limb. It is important to revisit these variations of anatomy as they may be relevant to explain clinical signs or during surgical procedures as detailed in this report.
ABSTRACT
A 38-year-old woman seropositive for hepatitis C developed headache, sensorineural hearing loss, encephalopathy, and retinal arteriolar occlusions. Brain MRI showed signal abnormalities in the basal ganglia and corpus callosum. These features are consistent with Susac syndrome, a multifocal central nervous system disorder of uncertain etiology. This is the first reported case of Susac syndrome in a patient with hepatitis C.
