We propose our experience in soft tissue reconstruction in Hemifacial microsomia using a free fascioadiposal flap.
Hemifacial microsomia (HFM) is a congenital disorder characterized by craniofacial ...malformation of one or both sides of the lower face. A 18-year-old female presented with hemifacial microsomia involving the left side. A free SCIA/SIEA fascioadiposal flap was transferred to the left face for soft tissue augmentation.
The immediate postoperative course of the patient was uneventful, with no complication and adequate augmentation in contour deformity was achieved. One year after the procedure, the patient presented a good resolution of the deformity with improved facial symmetry DISCUSSION: Reconstruction for facial contour deformities is still a challenging process and treatment for most cases is achieved only by soft tissue augmentation. Several microsurgical flaps have been proposed for restoration of facial asymmetry and improvement of facial volume and contour in these patients: deltopectoral, parascapular, anterolateral thigh, groin and deep inferior epigastric. This article reports our experience in facial soft tissue reconstruction with microsurgical superficial circumflex iliac artery/superficial inferior epigastric artery (SCIA/SIEA) fascioadiposal flap transfer in patient with HFM. This flap, which has a dual blood vascularization and pliant soft tissue, can provide an ideal treatment for soft tissue augmentation in hemifacial microsomia with optimal aesthetic results both in the face and at the donor site.
The free SCIA/SIEA fascioadiposal flap is a optimal choise option for soft tissue reconstruction with good esthetical outcome both in the face and at the donor site.
Facial augmentation, Free flaps, Free SCIA/SIEA flap, Hemifacial microsomia.
Purpose: RENEB, 'Realising the European Network of Biodosimetry and Physical Retrospective Dosimetry,' is a network for research and emergency response mutual assistance in biodosimetry within the ...EU. Within this extremely active network, a number of new dosimetry methods have recently been proposed or developed. There is a requirement to test and/or validate these candidate techniques and inter-comparison exercises are a well-established method for such validation.
Materials and methods: The authors present details of inter-comparisons of four such new methods: dicentric chromosome analysis including telomere and centromere staining; the gene expression assay carried out in whole blood; Raman spectroscopy on blood lymphocytes, and detection of radiation-induced thermoluminescent signals in glass screens taken from mobile phones.
Results: In general the results show good agreement between the laboratories and methods within the expected levels of uncertainty, and thus demonstrate that there is a lot of potential for each of the candidate techniques.
Conclusions: Further work is required before the new methods can be included within the suite of reliable dosimetry methods for use by RENEB partners and others in routine and emergency response scenarios.
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DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Purpose: A European network was initiated in 2012 by 23 partners from 16 European countries with the aim to significantly increase individualized dose reconstruction in case of large-scale ...radiological emergency scenarios.
Results: The network was built on three complementary pillars: (1) an operational basis with seven biological and physical dosimetric assays in ready-to-use mode, (2) a basis for education, training and quality assurance, and (3) a basis for further network development regarding new techniques and members. Techniques for individual dose estimation based on biological samples and/or inert personalized devices as mobile phones or smart phones were optimized to support rapid categorization of many potential victims according to the received dose to the blood or personal devices. Communication and cross-border collaboration were also standardized. To assure long-term sustainability of the network, cooperation with national and international emergency preparedness organizations was initiated and links to radiation protection and research platforms have been developed. A legal framework, based on a Memorandum of Understanding, was established and signed by 27 organizations by the end of 2015.
Conclusions: RENEB is a European Network of biological and physical-retrospective dosimetry, with the capacity and capability to perform large-scale rapid individualized dose estimation. Specialized to handle large numbers of samples, RENEB is able to contribute to radiological emergency preparedness and wider large-scale research projects.
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DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Trigeminal nerve damage after mandibulectomy is a condition that may occur not infrequently when oncologic resections of the maxillo-facial district are performed. In the last decades microsurgery ...has made possible effective osteomuscular reconstructions using vascularised free flaps. Nevertheless, this procedure, if assuring satisfactory results, involved the sacrifice of the mandibular nerve. Nowadays, supramicrosurgical innovation has shifted the gold-standard to a higher level, allowing the complete sensitive recovery after mandibulectomy. The cross-face nerve transfer technique is an innovative procedure that provides excellent nerve regeneration in mini-invasive operations, avoiding visible scars and any deficiency in donor sites. We suggest that the cross-face nerve transfer is the surgical modality of choice to restore lower lip and chin sensibility after mandibulectomy.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The high dose per pulse of electron beams produced by some mobile accelerators for intraoperative radiotherapy can affect output factor (OF) measurements, since the dose rate increases by a factor ...larger than two from the reference to the smallest radiation field. Aim of this work was to assess the capability of different types of detectors to measure OFs at high dose per pulse by comparison with alanine dosimeters, which are independent of dose rate.
Measurements were made in 9 and 7 MeV electron beams produced by a Novac 7 accelerator. PMMA cylindrical applicators with diameter of 100 mm (reference field), 70 mm, 60 mm, 50 mm and 40 mm were used. The dose per pulse varied from about 30 mGy, for the 100 mm applicator, to about 70 mGy, for the 40 mm applicator. OFs were determined using four types of plane-parallel ionization chambers (PTW Advanced Markus and Roos, IBA PPC40 and PPC05), two types of silicon diodes (PTW 60017 and IBA 3FG-3D), a PTW microDiamond and alanine dosimeters. Ionization chamber signals were corrected for ion recombination effects using a modified two-voltage-analysis method that includes the free-electron component.
A fairly good agreement was found between OFs measured by the three types of solid-state detectors and those measured by alanine. Differences were generally below 1% and maximum discrepancies around 2%. For the Advanced Markus and the PPC05 chambers differences from alanine results were below 1.7%. For the Roos and the PPC40 chambers agreement with alanine was within 2.3% down to the 50 mm applicator, while differences of several percent were found for the smallest applicator, most likely due to volume averaging effect. The variation of ion recombination correction factor with field size was below 1% for the Advanced Markus and the PPC05 chambers and up to about 10% for the Roos and the PPC40 chambers.
Comparison with alanine measurements demonstrated that all the detectors considered in this work can be used to measure OFs in high-dose-per-pulse electron beams with an accuracy of 2%, provided that appropriate corrections for ion recombination effects are applied when using ionization chambers.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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