The Use of Mean Gray Value (MGV) as a Guide to Tension-Reducing Strategies in Body Contouring Surgery Reduces Wound-Related Morbidity.

BACKGROUND: Currently there are no known structural parameters of the integument that can be measured noninvasively which are used in the planning of body contouring surgery. OBJECTIVES: The aim of this study was to see if mean gray value (MGV), when taken into account preoperatively, can reduce wound-related morbidity. METHODS: This project was a prospective cohort study. Ultrasound imaging of the subcutaneous tissue was performed prospectively on patients undergoing body contouring surgery to quantify the superficial fascial system so that average MGV could be calculated over the proposed surgical sites. Patients with average to poor MGV (≤0.127) were identified preoperatively for tension-reducing procedures. Wound complication rates were compared with rates in a retrospective cohort which did not undergo preoperative imaging. RESULTS: There were 115 patients in each of the 2 cohorts. There were 3 exclusions due to loss of ultrasound images, leaving 112 patients available for analysis in the prospective cohort. The cohorts were similar except for a higher incidence of patients with diabetes in the retrospective group (1 vs 9, P = 0.026). The wound complication rate was significantly reduced in the prospective group (5/112, 4.4%) when compared with the retrospective group (20/115, 17%, P = 0.0062). The revision and infection rates were also significantly reduced in the prospective group (1/112, 0.9%; 3/112, 2.6%) when compared with the retrospective group (8/115, 7%, P = 0.019; 10/115 8.6%, P = 0.051). CONCLUSIONS: MGV is a unique, patient- and area-specific structural parameter of the integument, and its measurement may be useful in reducing wound-related morbidity in body contouring surgery.

Hypoplasia of the Tentorium Cerebelli: Case Report and Review of the Literature.

The second largest intracranial specialization of the dura mater, the tentorium cerebelli, is a transverse fold that partially separates the cerebellum and cerebral hemispheres. During routine dissection of the posterior cranial fossa, a left-sided hypoplastic region of the tentorium cerebelli was observed. This fenestration was seen at the posterior portion of the tentorium as a posteromedial strip of tissue rising vertically to interface with the falx cerebri. Although isolated cases of tentorial hypoplasia have been reported in, for example, cases of Chiari II malformation, we believe isolated fenestration of this membrane is very rare, especially in the absence of the Chiari II malformation. The current case adds to the sparse literature on isolated tentorial defects and might be of interest to neurosurgeons or clinicians who review intracranial imaging.

Turmeric as a Possible Treatment for COVID-19-Induced Anosmia and Ageusia.

The coronavirus disease 2019 (COVID-19) pandemic has caused a calamitous perturbation of society worldwide. Anosmia and ageusia (or hyposmia and dysgeusia) have been recognized as two common expressions of COVID-19 infection that linger for days to weeks, and in rare cases are thought to be immutable. Time alone has hitherto proven most effective in their restoration, but turmeric, long believed by some to have medicinal properties, may be a swifter and surer alleviator of anosmia and ageusia. This case series reports the speedy and consequential restoration of taste and smell in two subjects infected with COVID-19 following ingestion of one 1000 mg dose of a turmeric supplement. In view of this, we propose that turmeric be considered in the treatment of anosmia and ageusia caused by COVID-19 infection.

A Rare Anatomical Variation of the Lesser Occipital Nerve.

The lesser occipital nerve (LON) is a cutaneous branch of the cervical plexus that arises from the second and sometimes the third spinal nerve and innervates the scalp. During routine dissection of the neck, the LON was observed to arise directly from the spinal accessory nerve. The aberrant nerve measured 1.9 mm in diameter and 10.2 cm in length. Although anatomical variations of the LON such as duplication and triplication have been observed, we believe the origination of this nerve directly and exclusively from the spinal accessory nerve is exceedingly rare. The current case adds to the sparse literature on the variations of the LON and might be of interest to clinicians treating neurological conditions or surgeons operating in the area.

Blood supply to the chorda tympani: A review and clinical applications.

The chorda tympani (CT) is important in gustatory sensation from the anterior two-thirds of the tongue and in secretomotor innervation to the submandibular and sublingual glands. Although the blood supply to the CT is not well delineated in the literature, some studies have shown that a posterior tympanic branch of the stylomastoid artery supplies CT at its origin from the mastoid segment of the facial nerve. We review the blood supply to the CT comprehensively. A better understanding of the vasculature involved is required to prevent iatrogenic injury during middle ear surgery and complications secondary to ischemia.

Adult Pineal Region Atypical Teratoid Rhabdoid Tumor: A Case for Aggressive Surgical and Chemoradiation Management with Comprehensive Literature Review.

BACKGROUND: Atypical teratoid rhabdoid tumor (ATRT) is a rare, highly malignant central nervous system neoplasm classified as an embryonal grade IV neoplasm by the World Health Organization. ATRT generally occurs in children younger than 3 years, with 85 pathologically confirmed cases reported in adults. It is most commonly supratentorial, with only 9 confirmed adult cases localized to the pineal region. CASE DESCRIPTION: The case is described of a 29-year-old man with a history of chronic migraines and a previously negative computed tomography scan of the head presenting with worsening headaches and new-onset diplopia with upward gaze palsy. Computed tomography and magnetic resonance imaging showed a hemorrhagic pineal mass with extension into the right thalamus. After resection, the immunohistochemical staining and cytogenetic profile proved consistent with ATRT, making it the ninth reported case of pineal ATRT in an adult, which was treated aggressively with good outcome. CONCLUSIONS: Adult ATRT is rare, especially in the pineal region, with only 9 cases reported. Because of the aggressiveness, ATRT must be considered in the differential diagnosis of pineal region lesions because early diagnosis and aggressive treatment are key to prolonged survival.