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Mayer HF, Coloccini A, Viñas JF. Three-Dimensional Printing in Breast Reconstruction: Current and Promising Applications. J Clin Med 2024; 13:3278. [PMID: 38892989 PMCID: PMC11172985 DOI: 10.3390/jcm13113278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/23/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
Three-dimensional (3D) printing is dramatically improving breast reconstruction by offering customized and precise interventions at various stages of the surgical process. In preoperative planning, 3D imaging techniques, such as computer-aided design, allow the creation of detailed breast models for surgical simulation, optimizing surgical outcomes and reducing complications. During surgery, 3D printing makes it possible to customize implants and precisely shape autologous tissue flaps with customized molds and scaffolds. This not only improves the aesthetic appearance, but also conforms to the patient's natural anatomy. In addition, 3D printed scaffolds facilitate tissue engineering, potentially favoring the development and integration of autologous adipose tissue, thus avoiding implant-related complications. Postoperatively, 3D imaging allows an accurate assessment of breast volume and symmetry, which is crucial in assessing the success of reconstruction. The technology is also a key educational tool, enhancing surgeon training through realistic anatomical models and surgical simulations. As the field evolves, the integration of 3D printing with emerging technologies such as biodegradable materials and advanced imaging promises to further refine breast reconstruction techniques and outcomes. This study aims to explore the various applications of 3D printing in breast reconstruction, addressing current challenges and future opportunities.
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Affiliation(s)
- Horacio F. Mayer
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), Buenos Aires C1053ABH, Argentina; (A.C.); (J.F.V.)
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Mayer HF, Palacios Huatuco RM, Pizarro Feijoo BA, Mazzaro EL. Silicone Pectoral Implant to Solve Aesthetic Chest Deformity After Pectoralis Flap Harvesting for Laryngotracheal Reconstruction. Aesthetic Plast Surg 2024; 48:1773-1777. [PMID: 37700195 DOI: 10.1007/s00266-023-03638-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND The pectoralis major musculocutaneous flap has been considered for decades the workhorse in head and neck reconstruction. However, the disadvantages of the pectoralis flap include the morbidity of the donor site in terms of cosmetic and functional results. A silicone pectoral implant can be used to solve such aesthetic chest deformity in male patients. METHODS A 33-years-old man with a history of cervical tracheoesophageal fistula after a blunt trauma due to a motorcycle accident, previously reconstructed with a pectoralis major flap, consulted our Plastic Surgery Department for an aesthetic defect of the donor site . The use of an anatomical pectoral implant was planned with the aim of aesthetic reshaping of the male chest. A pocket was created following the preoperative design to position a 190 cc pectoral implant. Dissection was performed in a subcutaneous plane that included the underneath adipose tissue layer and then over the pectoralis minor and the serratus muscle. Three months later, in a second stage, lipofilling of the depressed areas was performed with 100 ml of adipose tissue obtained from the abdomen. RESULTS After two years of follow-up, the patient obtained a satisfactory aesthetic result, with an improvement in the projection of the thorax and the symmetry of the body contour. As the implant was placed into the subcutaneous pocket, no functional compromise in shoulder flexion or adduction was detected during follow-up. CONCLUSIONS The pectoral implant technique seems safe and provides reshaping of the male chest wall, significantly improving the cosmetic appearance of the patient. In addition, its use with associated procedures such as lipofilling allows optimal results to be obtained. To the best of our knowledge, this is the first case to describe the use of a pectoral implant to solve donor site morbidity after pectoralis flap harvesting for any reconstructive purpose. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Horacio F Mayer
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), 4190 Peron St., 1st. floor, C1991ABB, Buenos Aires, Argentina.
| | - René M Palacios Huatuco
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), 4190 Peron St., 1st. floor, C1991ABB, Buenos Aires, Argentina
| | - Byron A Pizarro Feijoo
- Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), 4190 Peron St., 1st. floor, C1991ABB, Buenos Aires, Argentina
| | - Eduardo L Mazzaro
- Head and Neck Surgery Section, General Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute (IUHIBA), 4190 Peron St., C1181ACH, Buenos Aires, Argentina
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Duteille F, Chavoin JP, Leyx P, Samarut E. Interest of a 3D custom-made implant in the reconstruction of bone defects of the cranial vault. ANN CHIR PLAST ESTH 2024; 69:160-165. [PMID: 37516637 DOI: 10.1016/j.anplas.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/31/2023]
Abstract
The authors report a case of a patient managed for severe cranial vault depression following combined neurosurgery and radiotherapy. This situation caused major aesthetic discomfort and was potentially dangerous due to the mechanical weakness of the bone flap. The authors had a CAD (computer aided design) silicone elastomer custom-made implant made to fill perfectly the depression. Beforehand, an expansion was performed to cover the implant after removal of the radiated skin. The surgery and post-operative course raised no concerns. After one year of follow-up, the result is very good and the patient very satisfied, proving that this technique certainly has its place in the therapeutic arsenal when faced with a tissue defect of the cranial vault.
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Affiliation(s)
- F Duteille
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nantes University Hospital, 44093 Nantes, France.
| | - J P Chavoin
- Department of Plastic, Reconstructive and Aesthetic Surgery, Toulouse University Hospital, Toulouse, France
| | - P Leyx
- Anatomik modeling SAS, Engineer, Paris, France
| | - E Samarut
- Neurotraumatology and Neurosurgery Department, Nantes University Hospital, Nantes, France
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Cui L, Wang T, Liu L, Teng J, Qi H. Diagnostic value of high-frequency ultrasound for Poland syndrome. Acta Radiol 2023; 64:2646-2650. [PMID: 37218124 DOI: 10.1177/02841851231177394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND The imaging diagnosis of Poland syndrome is mostly computed tomography (CT) or magnetic resonance imaging (MRI), whereas high-frequency ultrasound for the diagnosis of Poland syndrome is relatively rare. PURPOSE To investigate the diagnostic value of high-frequency ultrasound for Poland syndrome. MATERIAL AND METHODS A retrospective analysis of 15 patients diagnosed with Poland syndrome was performed, and the characteristics of ultrasound images were summarized. RESULTS High-frequency ultrasound clearly depict the anatomical structures of each layer of the chest wall in patients with Poland syndrome. Ultrasonography mainly showed partial or total absence of the pectoralis major muscle on the affected side, and some of which were combined with the absence of the pectoralis minor muscle. The difference was statistically significant in the thickness of the affected chest wall compared with the healthy side (P < 0.01). Out of 15 cases with Poland syndrome, 11 were associated with ipsilateral brachydactyly or syndactyly, and high-frequency ultrasonography showed that the bifurcation position of the common palmar digital artery on the affected finger was lower than that on the healthy side. CONCLUSION High-frequency ultrasound is an effective imaging method for the diagnosis of Poland syndrome.
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Affiliation(s)
- Liyuan Cui
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
| | - Tiezheng Wang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
| | - Lihua Liu
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
| | - Jianbo Teng
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
| | - Hengtao Qi
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China
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Santanelli di Pompeo F, Sorotos M, Paolini G, D’Orsi G, Firmani G. The use of Fat-Augmented Latissimus Dorsi (FALD) flap for male Poland Syndrome correction: a case report. Case Reports Plast Surg Hand Surg 2022; 9:197-202. [PMID: 36105868 PMCID: PMC9467619 DOI: 10.1080/23320885.2022.2117701] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
We present a 23-year-old male patient with severe PS, characterized by marked left thoracic wall deformity. Reconstruction was performed using the Fat-Augmented Latissimus Dorsi flap, which was fixed to the chest wall hollowing corresponding to where the pectoralis major muscle was missing. Patient was satisfied with final aesthetic and functional result.
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Affiliation(s)
- Fabio Santanelli di Pompeo
- Department NESMOS – Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
- Chair of Plastic Surgery, Faculty of Medicine and Psychology, Sapienza University of Rome – Sant’Andrea Hospital, Rome, Italy
| | - Michail Sorotos
- Department NESMOS – Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Guido Paolini
- Department NESMOS – Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Gennaro D’Orsi
- Department NESMOS – Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Guido Firmani
- Department NESMOS – Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Chavoin JP, Facchini F, Martinot-Duquennoy V, Duteille F, Herlin C, Le Pimpec-Barthes F, Assouad J, Chevallier B, Tiffet O, Brouchet L, Leyx P, Grolleau-Raoux JL, Chaput B, Dahan M. [Congenital thoracic deformities and 3D custom-made implants. New classification based on a series of 789 treated cases]. ANN CHIR PLAST ESTH 2022; 67:393-403. [PMID: 36031493 DOI: 10.1016/j.anplas.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors present a new study on 789 cases of congenital thoracic malformations including 638 pectus excavatum and 151 Poland syndromes, according to a new classification which completes Chin's one. All these malformations were treated with silicone elastomer implants. The contribution of computer-aided design and manufacturing (CAD/CAM) since 2008 is essential. The one-stage surgical protocol is precisely described. The results are impressive, permanent, for life, and complications are rare. The authors evoke a common vascular etiopathogenesis theory at the embryonic stage and question the heavy techniques of invasive remodeling that are most often unjustified.
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Affiliation(s)
- J P Chavoin
- Service de chirurgie Plastique Reconstructrice et esthétique,Centre Hospitalier Universitaire de Toulouse-Rangueil, 1, avenue Jean Pouilhès, 31059, Toulouse, France.
| | - F Facchini
- Service de Chirurgie Pédiatrique, Hôpital Universitaire pédiatrique Meyer, Viale Gaetano Pieraccini, 24, 50139, Florence, Italie.
| | - V Martinot-Duquennoy
- Service de Chirurgie plastique reconstructrice et Esthétique CHU Hôpital Salengro, Avenue du Professeur Emile Laine, 59037, Lille, France.
| | - F Duteille
- Service de Chirurgie Plastique Reconstructrice et Esthétique, Centre des brûlés, CHU Hôtel Dieu, 1 Pl. Alexis-Ricordeau, 44039, Nantes, France.
| | - C Herlin
- Service de Chirurgie Plastique Reconstructrice et Esthétique CHU, Hôpital Lapeyronie, 371, avenue du Doyen Gaston Giraud, 34295, Montpellier, France.
| | - F Le Pimpec-Barthes
- Service de Chirurgie Thoracique et Transplantation pulmonaire Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France.
| | - J Assouad
- Service de Chirurgie Thoracique et Cardio-Vasculaire APHP Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France.
| | - B Chevallier
- Service de chirurgie thoracique et cervicale et transplantation pulmonaire Hôpital Haut-Lévêque CHU de Bordeaux, 33600, Pessac, France.
| | - O Tiffet
- Service de Chirurgie Générale et thoracique CHU Saint Etienne, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France.
| | - L Brouchet
- Service de Chirurgie Thoracique, Chu Hôpital Larrey, 24 Chem. de Pouvourville, 31400, Toulouse, France.
| | - P Leyx
- Ingénieur CAO Anatomik Modeling SAS, 19 rue Jean Mermoz, 31100, Toulouse, France.
| | - J L Grolleau-Raoux
- Service de Chirurgie plastique reconstructrice et Esthétique CHU Rangueil, 1 rue Jean Poulhès, 31054, Toulouse, France.
| | - B Chaput
- Service de Chirurgie plastique reconstructrice et Esthétique CHU Rangueil, 1 rue Jean Poulhès, 31054, Toulouse, France.
| | - M Dahan
- Service de Chirurgie Thoracique, Chu Hôpital Larrey, 24 Chem. de Pouvourville, 31400, Toulouse, France.
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Chavoin JP, Gandolfi S, Leyx P, Facchini F, Schirmer C, Grolleau JL, Lupon E, Chaput B. [Breasts and congenital chest-wall deformities: Surgical strategy with 3D implants]. ANN CHIR PLAST ESTH 2022; 67:404-413. [PMID: 35931576 DOI: 10.1016/j.anplas.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Computer-aided design and manufacturing of custom-made elastomer implants leads from a CT scan to fill in with precision, a congenital chest wall congenital deformity, both bone (pectus excavatum) and muscle (Poland Syndrome), resulting in a natural repositioning of the breasts. We report our 25 years' experience in 301 women (234 Pectus+64 Poland). Parietal correction must always be done in first intention. It is common to have to carry out a second stage in women with an additional mammaplasty especially in the presence of insufficient glandular volume or a fairly frequently associated tuberous breast.
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Affiliation(s)
- J-P Chavoin
- Service de chirurgie plastique reconstructrice et esthétique CHU Toulouse Rangueil, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France.
| | - S Gandolfi
- Service de chirurgie plastique reconstructrice et esthétique CHU Toulouse Rangueil, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France
| | - P Leyx
- Anatomik Modeling SAS, 19, rue Jean-Mermoz, 31100 Toulouse, France
| | - F Facchini
- Unit of pediatric surgery, Meyer Children's Hospital, Florence, Italie
| | - C Schirmer
- Plastic and reconstructive surgery, Hospital de la Piedad, Buenos-Aires, Argentine
| | - J-L Grolleau
- Service de chirurgie plastique reconstructrice et esthétique CHU Toulouse Rangueil, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France
| | - E Lupon
- Service de chirurgie plastique reconstructrice et esthétique CHU Toulouse Rangueil, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France
| | - B Chaput
- Service de chirurgie plastique reconstructrice et esthétique CHU Toulouse Rangueil, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France
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Zhu B. The Prospects of Computer Aided Furniture Design and Manufacturing. 2021 3RD INTERNATIONAL CONFERENCE ON ARTIFICIAL INTELLIGENCE AND ADVANCED MANUFACTURE 2021. [DOI: 10.1145/3495018.3495428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Bin Zhu
- B&B Development Research Centre of Leshan Normal University, China
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Development of A Surgical Treatment Algorithm for Breast Reconstruction in Poland Syndrome Patients Considering Severity, Sex, and BMI. J Clin Med 2021; 10:jcm10194515. [PMID: 34640539 PMCID: PMC8509377 DOI: 10.3390/jcm10194515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Poland syndrome is a rare, challenging combination of chest wall and breast deformities for reconstructive surgeons and selecting the treatment can prove difficult. This study aims to help surgeons in choosing the best viable option for treatment by sharing our institutional experience and proposing a guiding algorithm. Methods: A retrospective analysis of all patients with Poland syndrome undergoing treatment for breast and chest wall deformities at a single institution between December 2011 and May 2020 was performed. Medical charts were reviewed to allow for a description of patient demographics, treatment modalities and complications. A treatment algorithm to aid in selecting the adequate reconstructive option based on our institutional experience was formulated. Results: A total of 22 patients (six male, 16 female) were identified who received treatment for Poland Syndrome related deformities. Nine received microsurgical free flap reconstruction (three Deep Inferior Epigastric Perforator flaps, six Transverse Myocutaneous Gracilis flaps), two received reconstruction with a local flap (two Latissimus dorsi flaps), nine received implant based reconstruction, and two were treated with autologous free fat transfer only (17 in combination with other surgical methods). Conclusion: Free flap reconstruction with the TMG flap is a valid option for patients with low Body Mass Index (BMI), while Deep Inferior Epigastric Perforator flaps should be considered for patients with a higher BMI. Autologous free fat transfer proves to be a safe and efficient treatment option in mild cases of Poland syndrome for male and female patients, in combination with or without implant based reconstructive surgery. Multicentre studies should be conducted to achieve higher case numbers of this rare disease and support clinical decisions with more data.
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Li R, Ting YH, Youssef SH, Song Y, Garg S. Three-Dimensional Printing for Cancer Applications: Research Landscape and Technologies. Pharmaceuticals (Basel) 2021; 14:ph14080787. [PMID: 34451884 PMCID: PMC8401566 DOI: 10.3390/ph14080787] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 02/07/2023] Open
Abstract
As a variety of novel technologies, 3D printing has been considerably applied in the field of health care, including cancer treatment. With its fast prototyping nature, 3D printing could transform basic oncology discoveries to clinical use quickly, speed up and even revolutionise the whole drug discovery and development process. This literature review provides insight into the up-to-date applications of 3D printing on cancer research and treatment, from fundamental research and drug discovery to drug development and clinical applications. These include 3D printing of anticancer pharmaceutics, 3D-bioprinted cancer cell models and customised nonbiological medical devices. Finally, the challenges of 3D printing for cancer applications are elaborated, and the future of 3D-printed medical applications is envisioned.
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Lupon E, Chaput B, Moreno B, Grolleau JL, Chavoin JP. Correction of Calf Atrophy With a Custom-Made Silicone Implant for Reconstruction: An Update. Aesthet Surg J 2021; 41:NP243-NP244. [PMID: 33217753 PMCID: PMC8040248 DOI: 10.1093/asj/sjaa284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Benoit Chaput
- Department of Plastic Surgery, University Toulouse III Paul Sabatier, Toulouse, France
| | | | - Jean-Louis Grolleau
- Department of Plastic Surgery, University Toulouse III Paul Sabatier, Toulouse, France
| | - Jean-Pierre Chavoin
- Department of Plastic Surgery, University Toulouse III Paul Sabatier, Toulouse, France
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Choi J, Kim JH, Sung YE, Oh DY. Delayed periprosthetic seroma in a male Poland syndrome patient: A case report. Medicine (Baltimore) 2021; 100:e24974. [PMID: 33725865 PMCID: PMC7969252 DOI: 10.1097/md.0000000000024974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/11/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Custom-made implant is an accepted treatment option for treatment of chest deformity in Poland syndrome. Unlike the raised concerns and awareness for the long-term consequences of breast implants, the long-term complications of customized implants for special purposes like Poland syndrome has not been reported in the literature. PATIENT CONCERNS A 44-year-old male with Poland syndrome presented to our institution complaining of a large bulge and fluctuation on the right chest wall. This occurred after 14 years from the initial implant surgery for correction of chest wall deformity. Upon failure of resolution by multiple aspirations, workup was carried out under suspicion of implant associated malignancy. INTERVENTION Total Capsulectomy and implant removal was done. OUTCOMES Histology revealed chronic inflammation with fibrosis. Implant-associated malignancy was not found. He is being followed up with no signs of recurrence. LESSONS For rare cases of implant insertion such as Poland syndrome, awareness of delayed complications and workups based on suspicion of implant-associated malignancy is needed. Surgeon awareness and patient education is required.
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Affiliation(s)
| | | | - Yeoun Eun Sung
- Department of Hospital Pathology, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
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Shahrul Baharin N, Awadh Hashim E, Bin Huey Q, Chandran S. Reinforcing the vascular disruption theory of the genesis of Poland's syndrome: a rare association of diaphragmatic eventration in a preterm infant with severe musculoskeletal defects. BMJ Case Rep 2021; 14:14/1/e238392. [PMID: 33509875 PMCID: PMC7845722 DOI: 10.1136/bcr-2020-238392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
A preterm female infant was admitted at birth with respiratory distress. On examination, she had an asymmetric right chest wall and ipsilateral small hand. Air entry was reduced over the right chest. A clinical diagnosis of Poland's syndrome was made based on the hypoplasia of the right pectoral muscles, absent nipple, deformed ribs and symbrachydactyly of the ipsilateral hand. Chest X-ray suggested and ultrasound confirmed eventration of the right hemidiaphragm. 'Subclavian artery supply disruption sequence' (SASDS) theory by Bavnick and Weaver remains the most accepted pathogenic mechanism in Poland's syndrome. This case reinforces SASDS theory associated with the genesis of Poland's syndrome that relates to the pathogenicity of vascular disruption of subclavian artery, characteristics of which are unilateral pectoral defects, symbrachydactyly and eventration of the diaphragm. At 2 months, she underwent diaphragm plication. She is under review by our multidisciplinary surgical team for reconstruction of the chest deformity.
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Affiliation(s)
| | - Eman Awadh Hashim
- Neonatology, KK Women's and Children's Hospital, Singapore,Neonatology, Salmanya Medical Complex, Kingdom of Bahrain, Bahrain
| | - Quek Bin Huey
- Neonatology, KK Women's and Children's Hospital, Singapore,Neonatology, NUS Yong Loo Lin School of Medicine, Singapore,Neonatology, Duke NUS Medical School, Singapore
| | - Suresh Chandran
- Neonatology, KK Women's and Children's Hospital, Singapore,Neonatology, NUS Yong Loo Lin School of Medicine, Singapore,Neonatology, Duke NUS Medical School, Singapore,Neonatology, Lee Kong Chian School of Medicine, Singapore
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Chavoin JP, Lupon E, Moreno B, Leyx P, Grolleau JL, Chaput B. Correcting of Calf Atrophy With a Custom-Made Silicone Implant: Contribution of Three-Dimensional Computer-Aided Design Reconstruction: A Pilot Study. Aesthet Surg J 2021; 41:NP12-NP22. [PMID: 32593168 DOI: 10.1093/asj/sjaa171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Calf shape is an essential aesthetic parameter of the leg, and calf atrophy can lead to complex problems. The functional consequences of calf atrophy are generally moderate. Prefilled silicone gel implants represent the vast majority of currently placed prostheses, but this technique does not ensure optimal adaptation of the implant shape due to loss of volume. OBJECTIVES The aim of this study was to describe an innovative procedure for correcting acquired calf atrophy based on 3-dimensional (3D) modeling. METHODS The study involved 22 patients treated for calf atrophy caused by illness. Implants were made with solid rubber silicone, and 3D reconstructions were created by computer-aided design based on computed tomography scans. The implants were introduced through a horizontal popliteal incision. RESULTS Forty-one implants were placed. No cases of infection, hematoma, or compartment syndrome were encountered. We experienced 1 case of skin necrosis and 1 case of periprosthetic seroma. In addition, lipofilling was performed in 5 cases. Two patients sought to benefit from a surgical reduction in implant size. CONCLUSIONS Our innovative procedure to correct calf atrophy with custom solid rubber silicone implants produces a calf shape that better adapts to volume loss than prefilled silicone gel implants. The material maintains its shape and facilitates retrofitting of the prosthesis. There is no risk of hull formation or breakage, and the life span of the implants is limitless. This 3D computer-aided design approach has optimized our reconstructions. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Jean-Pierre Chavoin
- Department of Plastic Surgery, University Toulouse III Paul Sabatier, Toulouse, France
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Elise Lupon
- Department of Plastic Surgery, University Toulouse III Paul Sabatier, Toulouse, France
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | | | - Jean-Louis Grolleau
- Department of Plastic Surgery, University Toulouse III Paul Sabatier, Toulouse, France
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Benoit Chaput
- Department of Plastic Surgery, University Toulouse III Paul Sabatier, Toulouse, France
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Chavoin JP, Grolleau JL, Chaput B, Moreno B, Le Pimpec Barthes F, Assouad J, Brouchet L, Dahan M. Le pectus excavatum : chirurgie secondaire par implants. ANN CHIR PLAST ESTH 2019; 64:620-633. [DOI: 10.1016/j.anplas.2019.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
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Fang C, Zhang P, Qi X. Digital and intelligent liver surgery in the new era: Prospects and dilemmas. EBioMedicine 2019; 41:693-701. [PMID: 30773479 PMCID: PMC6442371 DOI: 10.1016/j.ebiom.2019.02.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/29/2019] [Accepted: 02/07/2019] [Indexed: 02/06/2023] Open
Abstract
Despite tremendous advances in traditional imaging technology over the past few decades, the intraoperative identification of lesions is still based on naked eye observation or pre-operative image evaluation. However, these two-dimensional image data cannot objectively reflect the complex anatomical structure of the liver and the detailed morphological features of the lesion, which directly limits the clinical application value of these imaging data in surgery in that it cannot improve the curative efficacy of surgery and the prognosis of the patient. This traditional mode of diagnosis and treatment has been changed by digital medical imaging technology in the new era with its significant function of accurate and efficient diagnosis of diseases, selection of reasonable treatment schemes, improvement of radical resection rate and reduction of surgical risk. In this paper, we reviewed the latest application of digital intelligent diagnosis and treatment technology related to liver surgery in the hope that it may help to achieve accurate treatment of liver surgery diseases.
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Affiliation(s)
- Chihua Fang
- CHESS, The First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou 510282, China.
| | - Peng Zhang
- CHESS, The First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou 510282, China
| | - Xiaolong Qi
- CHESS Frontier Center Working Party, The First Hospital of Lanzhou University, Lanzhou University, Lanzhou 730000, China.
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