ABSTRACT
Velopharyngeal competence reconstruction is indispensable for acquiring the fine speech and ingesting function. However, the maxillary prosthesis becomes unstable in some patients who have undergone extensive palatomaxillary. We present a case of total palatomaxillary defect resulting from squamous cell carcinoma ablation of the palate, which was reconstructed using a fibula-free osteocutaneous flap. Velopharyngeal competence was reconstructed owing to the flap so that the patient could ingest a soft diet and speak without hypernasality 2 weeks after surgery.
Subject(s)
Oral Surgical Procedures/methods , Plastic Surgery Procedures/methods , Surgical Flaps , Velopharyngeal Insufficiency/surgery , Aged , Bone Transplantation , Carcinoma, Squamous Cell/surgery , Deglutition Disorders/surgery , Fatal Outcome , Female , Fibula/surgery , Humans , Lymphatic Metastasis , Palatal Neoplasms/surgery , Skin Transplantation , Voice Disorders/surgeryABSTRACT
OBJECTIVE: To present our experience of cavernous nerve graft reconstruction, using an autologous nerve vein-guide technique, to restore potency. PATIENTS AND METHODS: Prostate cancers frequently require radical resection involving one or both cavernous nerves that usually results in erectile dysfunction; nerve grafting has been used to restore erectile function, but clinical results are unsatisfactory owing to inadequate surgical techniques. In all, eight patients with prostate cancer who required radical resection involving one cavernous nerve had sural nerve grafting, with two or three sutures using the autologous vein-guide technique, in our unit between 2004 and 2005. Because of the difficulty of performing microsurgical manoeuvres deep within the pelvic cavity, the nerve anastomosis might be unsatisfactory. RESULTS: Seven of the eight patients had spontaneous erectile activity after grafting and six of these patients were able to have intercourse. CONCLUSION: Sural nerve grafting using the autologous vein-guide technique is simple, has minimal morbidity, and yields good outcomes.
Subject(s)
Impotence, Vasculogenic/prevention & control , Neurosurgical Procedures/methods , Penis/innervation , Prostatectomy/adverse effects , Prostatic Neoplasms/surgery , Sural Nerve/transplantation , Aged , Follow-Up Studies , Humans , Impotence, Vasculogenic/etiology , Male , Middle Aged , Penis/surgery , Treatment OutcomeSubject(s)
Burns/surgery , Leg Injuries/surgery , Lymphedema/complications , Lymphoma/complications , Skin Transplantation/methods , Aged , Fires , Humans , Lymphedema/surgery , MaleABSTRACT
UNLABELLED: OBJECTIVE AND PATIENT: Both nasal cerebral heterotopia and encephalocele are rare congenital benign masses of neurogenic origin caused by an embryonic developmental abnormality. It is generally accepted that nasal heterotopia is a sequelae to encephalocele. This report presents an unusual case of nasal cerebral heterotopia and encephalocele arising in the same patient. The patient had a firm, solid mass measuring 1.5 x 1.0 cm on the bridge of the nose covered with normal skin and another mass in the nasal cavity obstructing the right nasal cavity. Computed tomography (CT) demonstrated that the nasal bone separated these masses. CT also showed a bony defect at the skull base. Surgery consisted of dividing the encephalocele and closure of the skull base fistulae, along with nasal subcutaneous mass enucleation. RESULTS: Intraoperative examination indicated the existence of a pit on the nasal bone where the pedicle of the nasal subcutaneous mass connected. Microscopic examination of the nasal cavity mass demonstrated meningoencephalocele, and examination of the nasal subcutaneous mass demonstrated nasal cerebral heterotopia, which was confirmed by immunohistochemical staining. After 10 months, complete removal of the subcutaneous nasal mass was recognized and there was no evidence of recurrence. CONCLUSION: Findings in this case suggest that the nasal cerebral heterotopias will result from encephalocele.
