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Purpose: Traditional evaluation of suspected carpal tunnel syndrome (CTS) involves a thorough history, physical examination, and nerve conduction velocity studies (NCS). The aim of the study is to evaluate whether ultrasound (US) is a valid alternative to the emg as a routine pre-operative examination, to evaluate patients with STC, comparing some us values with NCS findings pre and postopertively Methods: Only patients with symptoms, clinical examination, and NCS findings consistent with CTS were included in the study, according to the inclusion criteria. Four ultrasonographic variables were considered in treated patients: 1) CSPA (cross sectional pisiform area); 2) S-P dt: the largest diameter of the nerve in the same point; 3) Prox Area: the section area approximately 4 cm proximal to the pisiform; 4) Prox DT: the largest diameter in the same point. Each of these values was measured pre and postoperatively (three months after surgery) As for the emgraphic variables, the VCS and the SAP were taken into consideration, that is sensitive variables. The NCS and the ultrasound values are compared In this preliminary phase of the study, 25 patients were recruited. Results: A significant correlation was found between “CSPA” and “SAP” before and after surgery, As if the CSPA could be a reliable parameter for the diagnostic evaluations of these patients, as well as for any postoperative or post-therapeutic evaluation. Conclusions: Our results indicate that high-resolution ultrasound is informative in the evaluation of CTS and shows enlargement of the median nerve at the distal wrist crease in symptomatic patients. Therefore it is a reliable modality for imaging the wrist in patients with CTS. In addition ultrasound is well tolerated and safe. The extended role of US in STC diagnosis awaits further definition, these are preliminary findings to be confirmed by further studies with larger sample size

Introduction Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a dangerous complication of bisphosphonates, a class of pharmaceutical agents used in numerous bone disor- ders. No gold standard therapy exists, but recent literature suggests that, in advanced stages, the best results are achieved with aggressive debridement. In this paper, we report our experience of treatment of stage 3 BRONJ of the maxilla with extensive surgical debridement and reconstruction with a chimeric ALT-Vastus lateralis flap. Methods Five selected patients with stage 3 BRONJ underwent partial maxillectomy with dis- ease-free margins followed by immediate reconstruction with a chimeric ALT-Vastus lateralis free flap. Results Only two patients experienced minor complications. All other patients healed unevent- fully within two weeks and donor site morbidity was minimal. Conclusions Our data suggest that aggressive debridement and reconstruction with a chimeric ALT -Vastus lateralis flap is an effective option for the treatment of stage III BRONJ of the maxilla.

INTRODUCTION: The authors present an algorithm of partial breast reconstruction following quadrantectomy that allows to restore the breast volume defect with the use of pedicled perforator flaps. MATERIAL AND METHODS: Between March 2009 and May 2010, at the Plastic and Reconstructive Institute of University of Palermo, pedicled perforator flaps were used to integrate volume and/or breast skin in 12 patients after benign and malignant breast tumors. The flaps used were based on perforators of the thoraco-dorsal artery (TDAP) and of the intercostal arteries (ICAP). TDAP flaps were used to reconstruct defects in any breast quadrant, while ICAP perforator were used to reconstruct lateral and central inferior pole defects. RESULTS: All flaps survived completely. Breast size, shape and volume were satisfactorily restored. Contralateral breast procedure to adjust symmetry were not necessary. Donor sites scars were well hidden in the inframammary fold or under the brassiere. CONCLUSIONS : Partial breast reconstruction can be performed, in selected patients, with pedicled perforator flaps to restore both volume, shape and skin envelope. Donor site scars are negligible and better with the anterior ICAP because the scar is hidden in the submammary sulcus.