The articulated dual-supply pedicle for reduction mammoplasty.

Breast reduction surgery achieves symptomatic relief and improved quality of life for patients with excessive breast enlargement. Reduction mammoplasty has evolved over the last century with the introduction of multiple new pedicles and skin excision patterns utilizing the ample blood supply of the breasts. The superior pedicle is a relatively safe technique in small resections, while the superomedial pedicle, supplied by the internal mammary perforators, serves as a proper alternative in broader resections. We aim to introduce the dual-supply pedicle technique, taking advantage of the two efficient workhorse pedicles-the superior and superomedial. A retrospective study of 48 bilateral reduction mammoplasty patients operated over a 2-year period between 2017 and 2019 by a single surgeon (Y.W). Patient characteristics and postoperative outcome data were collected and evaluated. The novel surgical technique showed compatibility with different types of patients and breasts, forming excellent aesthetic outcomes. Complication rates were comparable or lower than previously published series. Major complications requiring revision surgery were encountered in 2 patients (2.08%) and minor complications in 11 patients (11.5%); 4 moderate surgical wound dehiscence, 6 minor surgical wound dehiscence and 1 fat necrosis. The Dual-Supply Pedicle Reduction Mammoplasty is a safe, reproducible technique, with a short learning curve, excellent aesthetical results, and an acceptable complication rate. Level of Evidence is Level III.

Long-Term Follow-Up of Post Radiation Complete Sinus Opacification in Sinonasal Cancer Patients.

OBJECTIVE: Treatment of sinonasal malignancies most often requires primary or postoperative radiation treatment. Post radiation sinonasal morbidity has been previously described; however, none addressed post-radiation sinus obstruction. Our objective was to investigate the long-term outcomes of post radiation complete isolated sinus opacification (CISO). METHODS: A retrospective analysis of sinonasal cancer patients treated with radiation therapy during the years 2002 to 2022. Clinical, imaging and treatment data were collected from patients' medical records. Only patients with at least 12 months of follow-up and available imaging for review were included. RESULTS: Out of 109 patients, 37 patients were identified to meet the inclusion criteria. Mean follow-up was 58 months. 35% of patients were diagnosed with persistent post radiation CISO with a mean onset of 4 months. All these patients remained asymptomatic, and their imaging remained stable during follow-up with none developing an expanding mucocele. Ethmoid sinus tumor involvement was found to be more prevalent in the CISO group (62% vs. 25%, p-value = 0.048) as well as chemotherapy/immunotherapy (54% vs. 38%, p-value = 0.046). Multivariant analysis revealed that ethmoid sinus involvement (OR = 9.516, p-value = 0.047) and adjuvant therapy, either chemotherapy/immunotherapy (OR = 10.75, p-value = 0.036) were found to be a predictive factor for complete opacification. CONCLUSION: Our study revealed that a substantial number of post-radiation patients develop a stable and persistent CISO, often in the frontal and sphenoid sinuses. These patients remained asymptomatic, and none required surgical intervention during nearly 5 years of follow-up. LEVEL OF EVIDENCE: 4 Laryngoscope, 2024.

Long Term Rigid Retained Foreign Object After Breast Augmentation: A Case Report and Literature Review.

Introduction: Retained foreign object (RFO) is a rare iatrogenic complication. This article presents an unprecedented case of a plastic RFO post-augmentation mammoplasty. Case Presentation: We present the case of a 32-year-old woman, 8 years after breast augmentation surgery, with a 4 year history of a palpable migrating mass in the superior lateral quadrant of her right breast with fluctuating levels of pain. Imaging studies included mammography tests, sonographic examinations, a Magnetic Resonance Imaging scan, and a Computed Tomography scan, all of which did not identify any pathological findings. Exploratory surgery discovered a syringe-tip cover in the implant pocket. Conclusion: Persistent complaints and symptoms accompanied by non-specific imaging studies warrant escalation of diagnostic methods, in line with a high awareness for the possibility of an RFO. As pocket lavage is a common practice in various surgeries, this report can serve as a valuable reminder for surgical teams to account for syringe covers and other disposable items at the end of all operations.