Search

Background: This research aimed to critically evaluate the safety and reliability of a new periosteal flap technique in cochlear implantation through a comprehensive surgical audit. A surgical audit was conducted on a cohort of 39 patients who underwent cochlear implantation at a tertiary teaching hospital from July 2020 to September 2021. The novel periosteal flap technique was utilized in all cases. Patients were followed up for a period ranging from 2 to 12 months. For comparison, outcomes were assessed by comparing 51 children who had undergone cochlear implant surgery between July 2017 and June 2019, utilizing the anteriorly based palva flap. A scoring system was employed to evaluate various aspects, including ease of surgical exposure, flap maneuverability, ease of closure after device fixation, immediate postoperative complications (up to 24 h), and delayed complications (up to 30 days). Scores ranging from 1 (fair assessment) to 4 (excellent assessment) were assigned, with a maximum score of 18 indicating optimal outcomes. Results: The comparison between the two groups revealed a reduced incidence of emissary vein injury and easier wound closure after device fixation in the novel periosteal flap group (p = 0.000). The mean total scores were significantly higher in the novel periosteal flap group, indicating superior outcomes. Only 2 out of 39 children with the novel flap experienced minor skin color changes during the initial postoperative period, which resolved within approximately 7 days. Major complications such as wound infection, hematoma, or device migration were not observed with the new periosteal flap. Furthermore, no flap revisions were required. Conclusions: The novel and innovative periosteal flap demonstrated both safety and reliability in cochlear implantation procedures. This well-vascularized and robust flap offered effective device coverage with minimal flap-related complications. Its time-saving nature further enhances its clinical utility. Additional validation from different medical centers would further corroborate the advantages of this easily implemented periosteal flap technique. Level of evidence: Level 3. [ABSTRACT FROM AUTHOR]

Laser-assisted in situ keratomileusis (LASIK) is one of the most commonly performed kerato-refractive surgery globally. Since its introduction in 1990, there has been a constant evolution in its technology to improve the visual outcome. The safety, efficacy, and predictability of LASIK are well known, but complications with this procedure, although rare, are not unknown. Literature review suggests that intraoperative complications include suction loss, free cap, flap tear, buttonhole flap, decentered ablation, central island, interface debris, femtosecond laser-related complications, and others. The postoperative complications include flap striae, flap dislocation, residual refractive error, diffuse lamellar keratitis, microbial keratitis, epithelial ingrowth, refractive regression, corneal ectasia, and others. This review aims to provide a comprehensive knowledge of risk factors, clinical features, and management protocol of all the reported complications of LASIK. This knowledge will help in prevention as well as early identification and timely intervention with the appropriate strategy for achieving optimal visual outcome even in the face of complications. [ABSTRACT FROM AUTHOR]

Our aim was to compare pedicled and island nasolabial flaps used for reconstruction of oral defects in terms of postoperative complications, recovery of sensitivity, and quality of life. We organised a retrospective cohort study of 49 patients who had had intraoral reconstruction with nasolabial pedicled (n- = 13) and island (n = 36) flaps. Twenty- two patients filled in a validated quality-of-life (QoL) questionnaire and we did sensitivity tests (sharp discrimination with the aid of a Semmes-Weinstein™ aesthesiometer). Descriptive and bivariate statistics were computed and probabilities of 0.05 were accepted as significant. There were 11 flap-related complications (22%), and the flap was totally necrotic in three patients (6%), all of whom had island flaps. There was a significant association between flap-related complications and the use of reconstruction plate p = 0.001, 95% CI 2.36 to 11.37) and advanced stage (T3 and T4 p = 0.01, 95% CI 1.45 to 5.26). Skin sensitivity recovered in both island and pedicled flaps. Patients treated with island flaps had significantly more problems with prosthetic rehabilitation than those treated with pedicled flaps. The relatively low morbidity and adequate functional and aesthetic results make the pedicled nasolabial flap a viable technique. De-epithelialisation of the pedicle in island flaps permits coverage of defects with unilateral flaps in a one-stage reconstruction. However, the pedicle may be excessively stretched, leading to ischaemic complications. [ABSTRACT FROM AUTHOR]