RESUMEN
INTRODUCTION: Autologous fat graft has become the gold-standard defect filling technique. "Lipostructure(©)" was described by Colman in 1994. It is perfectly codified and gives excellent results. The filling of superficial skin layers with the routine technique is difficult. It can be performed with a new technique developed by G. Magalon called micro-re-injection of autologous fat. TECHNIQUE: The adipose tissue is harvested without any incision, using a specific 2 mm cannula. The harvested fat tissue is centrifuged according to Coleman's recommendations. Re-injection of purified fat is performed with 0.8 mm specific cannulas, without any incision. 500-micron grafts are injected in multiple layers in the subdermal stratum. DISCUSSION: This autologous fat graft respects Coleman's procedure principles and preserves the histological structure. This technique is well adapted for facial defects, especially for the lips. It is more precise because the fat deposits are thinner. It does not require any skin incision. It proved to be less painful for our patients, and there was less postoperative edema than with the reference technique. Micro re-injection broadens the indications of autologous fat tissue graft in the fields of plastic (lip, eyelids) and reconstructive (retractile scar) surgery.
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Tejido Adiposo/trasplante , Microinyecciones/métodos , Tejido Adiposo/cirugía , Femenino , Supervivencia de Injerto , Humanos , Procedimientos de Cirugía Plástica/métodos , Recolección de Tejidos y Órganos/métodos , Trasplante AutólogoAsunto(s)
Calcinosis/diagnóstico por imagen , Vértebras Cervicales/diagnóstico por imagen , Trastornos de Deglución/etiología , Interpretación de Imagen Asistida por Computador , Músculos del Cuello/diagnóstico por imagen , Dolor de Cuello/etiología , Enfermedades Faríngeas/diagnóstico por imagen , Intensificación de Imagen Radiográfica , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Tendinopatía/diagnóstico por imagen , Tendones/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Trastornos de Deglución/diagnóstico por imagen , Diagnóstico Diferencial , Discitis/diagnóstico por imagen , Humanos , Masculino , Dolor de Cuello/diagnóstico por imagenRESUMEN
INTRODUCTION: Lobular capillary hemangioma is a frequent benign vascular inflammatory lesion of the skin tissue. It rarely reaches the mucous membrane, and the nasal fossa involvement is exceptional. CASE REPORT: A 68-year-old woman presented with an ulcerous hemorrhagic mass blocking the left nasal fossa, which had appeared a few weeks after a wasp sting in the nose. The insect was evacuated only three weeks after the sting. The clinical and radiological data suggested malignancy. Biopsy under local anesthesia proved non-contributory and was complicated by 1 week's hospitalization for severe nosebleed. Surgical excision under video-endoscopy confirmed diagnosis. At 31 months' follow-up, the patient was free of recurrence. DISCUSSION/CONCLUSION: The pathogeny of lobular capillary hemangioma is uncertain. No previous cases affecting the mucous membrane after insect sting have been reported. Except in the typical contexts of long-term packing or pregnancy, diagnosis can be difficult and misleading. It can mimic a malignant pathology. Its rich vascularization requires caution during biopsy, and the risk of recurrence requires excision to be complete.
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Granuloma Piogénico/diagnóstico , Granuloma Piogénico/etiología , Mordeduras y Picaduras de Insectos/complicaciones , Cavidad Nasal , Enfermedades Nasales/diagnóstico , Enfermedades Nasales/etiología , Avispas , Anciano , Animales , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Granuloma Piogénico/cirugía , Humanos , Cavidad Nasal/diagnóstico por imagen , Cavidad Nasal/patología , Cavidad Nasal/cirugía , Enfermedades Nasales/cirugía , Radiografía , Resultado del TratamientoRESUMEN
Hearing loss is routinely estimated from the audiogram, even though this measure gives only a rough approximation of hearing. Indeed, cochlear regions functioning poorly, if at all, called dead regions, are not detected by a simple audiogram. To detect cochlear dead regions, additional measurements of psychophysical tuning curves or thresholds in background noise (TEN test) are required. A first aim of this study was to assess the presence of dead regions after impulse noise trauma using psychophysical tuning curves. The procedure we used was based on a compromise between the need to collect reliable estimates of psychophysical tuning curves and the limited time available to obtain these estimates in a hospital setting. Psychophysical tuning curves were measured using simultaneous masking with a 2-alternative forced choice paradigm, where the target was randomly placed in one of the two masker presentations. It is well known that some components of noise-induced hearing loss are reversible. A second aim of this study was to examine the potential recovery of dead regions after acoustic trauma. A third issue addressed in this article was the relationship between noise-induced dead regions and tinnitus. We found that 70% of the subjects had dead regions after noise trauma, while 88% reported tinnitus. Moreover, we found that the extent of dead regions probably diminished in about 50% of subjects, which highlights the ability of the human auditory system to recover from noise-induced hearing loss.
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Percepción Auditiva , Cóclea/fisiopatología , Armas de Fuego , Pérdida Auditiva Provocada por Ruido/fisiopatología , Pérdida Auditiva Provocada por Ruido/psicología , Enfermedades Profesionales/fisiopatología , Enfermedades Profesionales/psicología , Estimulación Acústica , Adulto , Anciano , Audiometría , Umbral Auditivo , Cóclea/lesiones , Pérdida Auditiva Provocada por Ruido/diagnóstico , Pérdida Auditiva Provocada por Ruido/etiología , Humanos , Persona de Mediana Edad , Personal Militar , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/etiología , Exposición Profesional , Enmascaramiento Perceptual , Psicoacústica , Recuperación de la Función , Índice de Severidad de la Enfermedad , Acúfeno/fisiopatología , Acúfeno/psicología , Adulto JovenRESUMEN
UNLABELLED: We report a case of a parathyroid adenoma during a long term lithium treatment without therapeutic overdose. CASE REPORT: A 73-years-old woman presented a demonstrative biological syndrome with hypercalcemia, elevated parathormone, normal urinary cyclic AMP, normocalciuria. CONCLUSION: This lithium induced hyperparathyroidism differs from the classic primary hyperparathyroidism with parthyroid adenoma where urinary cyclic AMP excretion is elevated and where there is hypercalciuria. Lithium is blocking the negative feedback of calcium on parathormone secretion and stimulates the growth of parathyroid adenoma. Treatment is surgical and consists in adenoma ablation. Calcemia follow up is indicated in patients with long term lithium therapy