The Experts below are selected from a list of 72 Experts worldwide ranked by ideXlab platform
David G Brodland - One of the best experts on this subject based on the ideXlab platform.
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the paramidline forehead flap a clinical and microanatomic study
Dermatologic Surgery, 2016Co-Authors: Landon E Stigall, Tracy B Bramlette, John A Zitelli, David G BrodlandAbstract:BACKGROUND The traditional paramedian forehead flap (FHF) is an axial flap based on the Supratrochlear Artery (STA). Doppler examination is often used to ensure inclusion of the STA within the flap. The authors hypothesized that a FHF pedicle design could be simplified to extend from the midline of the glabella to 1.2 cm lateral to the midline without compromising outcomes. OBJECTIVE To compare clinical outcomes and vessel densities of 2 FHF designs. METHODS Two FHF designs were used to repair fifty nasal defects. One was based on Doppler identification of the STA; the other on clinical measurements from the glabellar midline (with no effort to identify the STA). Clinical outcomes, complication rates, and pedicle vasculature of both groups were compared. RESULTS There was no significant difference in flap survival or complication rate. Forehead flaps designed on the paramidline glabella had more arteries within their pedicles than Doppler-based FHFs (p < .05). Small arteries predominated, whereas larger arteries were infrequent in both groups. Size and number of arteries were not related to flap survival. CONCLUSION A paramidline FHF has equivalent clinical outcomes as a flap based on the STA. A simple and reproducible design of the FHF using only surface landmarks is described.
Regan Guilfoyle - One of the best experts on this subject based on the ideXlab platform.
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Total Nose and Upper Lip Replantation: A Case Report and Literature Review.
Plastic and Reconstructive Surgery - Global Open, 2018Co-Authors: Kate Elzinga, Abelardo Medina, Regan GuilfoyleAbstract:The nose plays a critical role in olfaction, air filtration and humidification, and facial aesthetics. Most nasal amputations result from animal bites, human bites, and lacerations from glass. Successful replantation yields the best aesthetic and functional outcomes and is preferred compared with multistage nasal reconstruction. However, nasal replantation is technically challenging; establishing venous outflow can be particularly difficult. A 17-year-old male sustained a complete nose and upper lip amputation in a motor vehicle accident. The midface segment was emergently replanted. Two arteries (left dorsal nasal Artery, left superior labial Artery) and 1 vein (branch of the left Supratrochlear Artery) were anastomosed using microsurgical technique. A vein graft, systemic anticoagulation, and postoperative leeching were important adjuncts. Total operative time was 10 hours. Cold ischemia time was 2 hours and warm ischemia time was 1 hour. Two arteries were anastomosed to minimize the risk of ischemia of the nose and/or upper lip. Complete survival of the replanted segment was achieved. Eighteen months postoperatively, the patient has bilateral nasal patency, intact septal support, and an excellent aesthetic result. All efforts should be made to establish a venous anastomosis during nasal replantation to maximize functional and aesthetic outcomes. Partial necrosis is common following Artery-only replantation, leading to tissue loss and contracture.
Fikret Cinar - One of the best experts on this subject based on the ideXlab platform.
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a reliable surface landmark for localizing Supratrochlear Artery medial canthus
Otolaryngology-Head and Neck Surgery, 2008Co-Authors: Mehmet Birol Ugur, Ahmet Savranlar, Lokman Uzun, Hudaverdi Kucuker, Fikret CinarAbstract:Objective To determine the reliability of medial canthus as a surface landmark to locate Supratrochlear vascular pedicle. Study Design and Setting The distance from medial canthal line to Supratrochlear vascular pedicle was measured in 57 healthy volunteers (Doppler imaging study) and also in 15 fresh cadavers. Results In the Doppler study, the pedicle was found at most 3 mm lateral or medial to medial canthus (mean ± SD, 0.8 ± 0.7 mm). SVP mark tended to be medial to the medial canthus mark in females (males, 6; females, 42), whereas it was lateral to it in males (males, 20; females, 5). In the cadaver study, the pedicle was found 0.7 mm away from medial canthus on average. Conclusion Medial canthus can be used as a reliable landmark for paramedian forehead flaps. When Doppler examination fails, pedicle may be found at most 3 mm away from medial canthus. SVP is more commonly located lateral to medial canthus in males and medial to it in females.
Landon E Stigall - One of the best experts on this subject based on the ideXlab platform.
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the paramidline forehead flap a clinical and microanatomic study
Dermatologic Surgery, 2016Co-Authors: Landon E Stigall, Tracy B Bramlette, John A Zitelli, David G BrodlandAbstract:BACKGROUND The traditional paramedian forehead flap (FHF) is an axial flap based on the Supratrochlear Artery (STA). Doppler examination is often used to ensure inclusion of the STA within the flap. The authors hypothesized that a FHF pedicle design could be simplified to extend from the midline of the glabella to 1.2 cm lateral to the midline without compromising outcomes. OBJECTIVE To compare clinical outcomes and vessel densities of 2 FHF designs. METHODS Two FHF designs were used to repair fifty nasal defects. One was based on Doppler identification of the STA; the other on clinical measurements from the glabellar midline (with no effort to identify the STA). Clinical outcomes, complication rates, and pedicle vasculature of both groups were compared. RESULTS There was no significant difference in flap survival or complication rate. Forehead flaps designed on the paramidline glabella had more arteries within their pedicles than Doppler-based FHFs (p < .05). Small arteries predominated, whereas larger arteries were infrequent in both groups. Size and number of arteries were not related to flap survival. CONCLUSION A paramidline FHF has equivalent clinical outcomes as a flap based on the STA. A simple and reproducible design of the FHF using only surface landmarks is described.
Kate Elzinga - One of the best experts on this subject based on the ideXlab platform.
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Total Nose and Upper Lip Replantation: A Case Report and Literature Review.
Plastic and Reconstructive Surgery - Global Open, 2018Co-Authors: Kate Elzinga, Abelardo Medina, Regan GuilfoyleAbstract:The nose plays a critical role in olfaction, air filtration and humidification, and facial aesthetics. Most nasal amputations result from animal bites, human bites, and lacerations from glass. Successful replantation yields the best aesthetic and functional outcomes and is preferred compared with multistage nasal reconstruction. However, nasal replantation is technically challenging; establishing venous outflow can be particularly difficult. A 17-year-old male sustained a complete nose and upper lip amputation in a motor vehicle accident. The midface segment was emergently replanted. Two arteries (left dorsal nasal Artery, left superior labial Artery) and 1 vein (branch of the left Supratrochlear Artery) were anastomosed using microsurgical technique. A vein graft, systemic anticoagulation, and postoperative leeching were important adjuncts. Total operative time was 10 hours. Cold ischemia time was 2 hours and warm ischemia time was 1 hour. Two arteries were anastomosed to minimize the risk of ischemia of the nose and/or upper lip. Complete survival of the replanted segment was achieved. Eighteen months postoperatively, the patient has bilateral nasal patency, intact septal support, and an excellent aesthetic result. All efforts should be made to establish a venous anastomosis during nasal replantation to maximize functional and aesthetic outcomes. Partial necrosis is common following Artery-only replantation, leading to tissue loss and contracture.