Comparison of Single- Versus Dual-Vector Technique Using Facial Suspension Threads: A Cadaveric Study Using Skin Vector Displacement Analysis.

BACKGROUND: Facial suspension threads have been successfully used for facial soft-tissue repositioning. When using facial suspension threads, it is unclear which technique and/or material has the greatest lifting effect for the middle and lower face or which technique/material best reduces the appearance of the jowls. MATERIAL AND METHODS: Three female and 2 male cephalic specimens of Caucasian ethnicity (65.2 ± 8.3 years; 20.72 ± 2.6 kg/m) were analyzed in an upright secured position. Polydioxanone and polycaprolactone bidirectional barbed facial suspension threads were introduced by an 18 G, 100 mm cannula. The single-vector technique aimed toward the labiomandibular sulcus, and the dual-vector technique aimed toward the labiomandibular sulcus and the mandibular angle. Computation of vertical lifting, horizontal lifting, and volume reduction at the jowls and along the jawline were calculated using 3D imaging. RESULTS: The dual-vector technique effected a greater vertical lifting effect (4.45 ± 2.78 mm vs 2.99 ± 2.23 mm) but a reduced horizontal lifting effect (0.33 ± 1.34 mm vs 0.49 ± 1.32 mm). The dual-vector technique effected less volume reduction at the jowls 0.32 ± 0.24 cc versus 0.41 ± 0.46 cc and less volume reduction along the jawline 0.46 ± 0.48 cc versus 0.87 ± 0.53 cc (dual-vector vs single-vector). CONCLUSION: This study provides evidence resulting from cadaveric observations for the overall nonsuperiority of the dual-vector technique compared with the single-vector technique.

Photodynamic nasal SARS-CoV-2 decolonization shortens infectivity and influences specific T-Cell responses.

Background: The main objective was to evaluate the efficacy of intranasal photodynamic therapy (PDT) in SARS-CoV-2 mildly symptomatic carriers on decreasing the infectivity period. SARS-CoV-2-specific immune-stimulating effects and safety were also analysed. Methods: We performed a randomized, placebo-controlled, clinical trial in a tertiary hospital (NCT05184205). Patients with a positive SARS-CoV-2 PCR in the last 48 hours were recruited and aleatorily assigned to PDT or placebo. Patients with pneumonia were excluded. Participants and investigators were masked to group assignment. The primary outcome was the reduction in in vitro infectivity of nasopharyngeal samples at days 3 and 7. Additional outcomes included safety assessment and quantification of humoral and T-cell immune-responses. Findings: Patients were recruited between December 2021 and February 2022. Most were previously healthy adults vaccinated against COVID-19 and most carried Omicron variant. 38 patients were assigned to placebo and 37 to PDT. Intranasal PDT reduced infectivity at day 3 post-treatment when compared to placebo with a ß-coefficient of -812.2 (CI95%= -478660 - -1.3, p<0.05) infectivity arbitrary units. The probability of becoming PCR negative (ct>34) at day 7 was higher on the PDT-group, with an OR of 0.15 (CI95%=0.04-0.58). There was a decay in anti-Spike titre and specific SARS-CoV-2 T cell immunity in the placebo group 10 and 20 weeks after infection, but not in the PDT-group. No serious adverse events were reported. Interpretation: Intranasal-PDT is safe in pauci-symptomatic COVID-19 patients, it reduces SARS-CoV-2 infectivity and decelerates the decline SARS-CoV-2 specific immune-responses.

Salivary Stone Pneumatic Lithotripsy in a Live Porcine Model.

The purpose of this study is to evaluate the efficacy of endoscopic fragmentation and removal of artificial calculi in a live porcine model employing intracorporeal pneumatic lithotripsy. In this experimental study, 7 submandibular ducts were accessed and artificial calculi placed. A salivary pneumatic lithotripter probe was inserted through an interventional sialendoscope to fragment the calculi. A salivary duct catheter was then used to flush stone fragments, followed by endoscopy to assess complete fragmentation and ductal trauma. Ultimately, 7 artificial stones (3-10 mm, 4F/5F) were successfully fragmented without causing significant endoluminal trauma. Number of pulses for adequate stone fragmentation averaged 20 (range, 5-31). In all cases, stone fragments were successfully flushed out with the salivary duct catheter. Postprocedure endoscopy confirmed ductal integrity in all 7 ducts. While more studies are needed, this preliminary animal model demonstrates efficacy of endoscopic pneumatic lithotripsy for the management of sialolithiasis.

Endoscopic Salivary Stone Fragmentation with Pneumatic Lithotripsy in a Simulation Model.

OBJECTIVE: To evaluate the endoscopic fragmentation and removal of human salivary stones by employing intracorporeal pneumatic lithotripsy in a clinical simulation model of the submandibular gland. STUDY DESIGN: Simulation model evaluating endoscopic management of human salivary stones. SETTING: Laboratory. SUBJECTS AND METHODS: A flexible nitinol contact probe adapted to a CO2-driven handheld salivary pneumatic lithotripter was deployed through a sialendoscope to disrupt parotid (n = 1) and submandibular (n = 8) stones embedded in separate 3-dimensionally printed plastic models of the mouth and submandibular glands. Simulation included endoscopic removal of small stone fragments by standard basket retrieval supplement by irrigation and suction through a salivary duct introducer system. Correlations were made between stone volume and density with the duration of the procedures and number of pneumatic pulses required to disrupt and remove stone fragments. RESULTS: Among the 8 stones fragmented sufficiently to permit either full endoscopic removal (n = 7) or removal of the central portion leaving an adherent rind to the duct (n = 1), the average procedure time (32 minutes) and the average number of pneumatic pulses (98) correlated with stone density (range, 0.4-1.5 g/mL) and stone volume (range, 0.05-0.4 mL). One stone was sufficiently resistant to fragmentation as to prevent successful removal. CONCLUSIONS: Modification to the evolving technology of intracorporeal pneumatic management of nephrolithiasis was successfully applied in an ex vivo model to simulate management of sialolithiasis.