Colgajo nautilus y colgajo en muleta taurina para defectos quirúrgicos faciales periorificiales / Nautilus Flap and Bullfighter Crutch Flap for the Repair of Periorificial Surgical Defects of the Face

Antecedentes La reconstrucción de defectos quirúrgicos en regiones anatómicas próximas a bordes palpebrales, fosas nasales o boca es un reto debido su tendencia a ser deformadas por la tensión del cierre directo o los colgajos cutáneos. El empleo de nuevas técnicas reconstructivas que eviten la retracción de estas zonas sensibles puede suponer un avance importante. Pacientes y métodos Se emplean 2 nuevos diseños, el colgajo nautilus y el colgajo en muleta taurina, para la reconstrucción de defectos quirúrgicos periorificiales, realizando una recolección retrospectiva de los mismos en las zonas periparpebral, perivestibular nasal y peribucal. El colgajo nautilus se empleó en 4 pacientes con defectos periparpebrales y 2 peribucales. El colgajo en muleta taurina se utilizó para la reconstrucción de 14 defectos en ala nasal. Resultados En los 20 pacientes se obtuvieron resultados muy satisfactorios tanto a nivel estético como funcional, sin la aparición de ectropión, colapso del vestíbulo nasal o asimetría de borde labial. No se observó necrosis en ningún caso. Conclusiones Proponemos el colgajo nautilus y el colgajo en muleta taurina como una excelente opción reconstructiva para defectos quirúrgicos localizados en zonas periorificiales (AU)

Background Reconstruction of surgical defects located close to eyelid edges, nostrils, or the mouth is challenging, as tension generated by direct closure or skin flaps in these sensitive regions tends to cause distortion. New repair techniques that prevent retraction may significantly improve outcomes. Patients and methods Retrospective study of the use of 2 novel flap designs—the nautilus flap and the bullfighter crutch flap—to repair surgical defects in the peripalpebral, perivestibular, nasal, and perioral areas. The nautilus flap was used to repair 4 peripalpebral defects and 2 perioral defects, and the bullfighter crutch flap to repair 14 nasal ala defects.Results Cosmetic and functional outcomes were very satisfactory in all 20 patients, with no cases of ectropion, nasal vestibule collapse, or labial asymmetry. Necrosis did not occur in any of the cases. Conclusions The nautilus and bullfighter crutch flaps appear to be excellent choices for reconstructing surgical defects in periorificial areas (AU)

[Translated article] Nautilus Flap and Bullfighter Crutch Flap for the Repair of Periorificial Surgical Defects of the Face / Colgajo nautilus y colgajo en muleta taurina para defectos quirúrgicos faciales periorificiales

Background Reconstruction of surgical defects located close to eyelid edges, nostrils, or the mouth is challenging, as tension generated by direct closure or skin flaps in these sensitive regions tends to cause distortion. New repair techniques that prevent retraction may significantly improve outcomes. Patients and methods Retrospective study of the use of 2 novel flap designs—the nautilus flap and the bullfighter crutch flap—to repair surgical defects in the peripalpebral, perivestibular, nasal, and perioral areas. The nautilus flap was used to repair 4 peripalpebral defects and 2 perioral defects, and the bullfighter crutch flap to repair 14 nasal ala defects.Results Cosmetic and functional outcomes were very satisfactory in all 20 patients, with no cases of ectropion, nasal vestibule collapse, or labial asymmetry. Necrosis did not occur in any of the cases. Conclusions The nautilus and bullfighter crutch flaps appear to be excellent choices for reconstructing surgical defects in periorificial areas (AU)

Antecedentes La reconstrucción de defectos quirúrgicos en regiones anatómicas próximas a bordes palpebrales, fosas nasales o boca es un reto debido su tendencia a ser deformadas por la tensión del cierre directo o los colgajos cutáneos. El empleo de nuevas técnicas reconstructivas que eviten la retracción de estas zonas sensibles puede suponer un avance importante. Pacientes y métodos Se emplean 2 nuevos diseños, el colgajo nautilus y el colgajo en muleta taurina, para la reconstrucción de defectos quirúrgicos periorificiales, realizando una recolección retrospectiva de los mismos en las zonas periparpebral, perivestibular nasal y peribucal. El colgajo nautilus se empleó en 4 pacientes con defectos periparpebrales y 2 peribucales. El colgajo en muleta taurina se utilizó para la reconstrucción de 14 defectos en ala nasal. Resultados En los 20 pacientes se obtuvieron resultados muy satisfactorios tanto a nivel estético como funcional, sin la aparición de ectropión, colapso del vestíbulo nasal o asimetría de borde labial. No se observó necrosis en ningún caso. Conclusiones Proponemos el colgajo nautilus y el colgajo en muleta taurina como una excelente opción reconstructiva para defectos quirúrgicos localizados en zonas periorificiales (AU)

Nautilus Flap and Bullfighter Crutch Flap for the Repair of Periorificial Surgical Defects of the Face. / Colgajo nautilus y colgajo en muleta taurina para defectos quirúrgicos faciales periorificiales.

BACKGROUND: Reconstruction of surgical defects located close to eyelid edges, nostrils, or the mouth is challenging, as tension generated by direct closure or skin flaps in these sensitive regions tends to cause distortion. New repair techniques that prevent retraction may significantly improve outcomes. PATIENTS AND METHODS: Retrospective study of the use of 2 novel flap designs-the nautilus flap and the bullfighter crutch flap-to repair surgical defects in the peripalpebral, perivestibular, nasal, and perioral areas. The nautilus flap was used to repair 4 peripalpebral defects and 2 perioral defects, and the bullfighter crutch flap to repair 14 nasal ala defects. RESULTS: Cosmetic and functional outcomes were very satisfactory in all 20 patients, with no cases of ectropion, nasal vestibule collapse, or labial asymmetry. Necrosis did not occur in any of the cases. CONCLUSIONS: The nautilus and bullfighter crutch flaps appear to be excellent choices for reconstructing surgical defects in periorificial areas.

[Translated article] Nautilus Flap and Bullfighter Crutch Flap for the Repair of Periorificial Surgical Defects of the Face.

BACKGROUND: Reconstruction of surgical defects located close to eyelid edges, nostrils, or the mouth is challenging, as tension generated by direct closure or skin flaps in these sensitive regions tends to cause distortion. New repair techniques that prevent retraction may significantly improve outcomes. PATIENTS AND METHODS: Retrospective study of the use of 2 novel flap designs-the nautilus flap and the bullfighter crutch flap-to repair surgical defects in the peripalpebral, perivestibular, nasal, and perioral areas. The nautilus flap was used to repair 4 peripalpebral defects and 2 perioral defects, and the bullfighter crutch flap to repair 14 nasal ala defects. RESULTS: Cosmetic and functional outcomes were very satisfactory in all 20 patients, with no cases of ectropion, nasal vestibule collapse, or labial asymmetry. Necrosis did not occur in any of the cases. CONCLUSIONS: The nautilus and bullfighter crutch flaps appear to be excellent choices for reconstructing surgical defects in periorificial areas.

Utilidad de la PET-TC en la valoración de la respuesta precoz al tratamiento en el linfoma B difuso de celula grande. Resultados preliminares / Utility of the PET-CT in the evaluation of early response to treatment in the diffuse large B-cell lymphoma. Preliminary results

Objetivo. Valorar la utilidad de la PET-TC con FDG tras los primeros ciclos de quimioterapia en la predicción de la respuesta al tratamiento en pacientes con linfoma B difuso de célula grande. Metodologia. Se incluyeron 20 pacientes (edad media: 48), 16 en la estadificación inicial y 4 por recidiva. La PET-TC se realizó en tres tiempos: 1) Basal, 2) Tras el primer-tercer ciclo (valoración de respuesta precoz), y 3) Al finalizar el tratamiento (valoración de respuesta final). Los hallazgos de la valoración precoz fueron correlacionados con la valoración final y el seguimiento. La valoración de la respuesta se estableció según la disminución de la captación de las lesiones (SUVmax). En la valoración precoz el indicador de buena respuesta (IBR) fue la reducción del SUVmax > 50% o la desaparición. Al final del tratamiento se determinó la respuesta metabólica completa (RMC) en ausencia de focos. El seguimiento fue superior a los 19 meses, estableciendo progresión/recidiva o sin evidencia de enfermedad (SEE). Resultados. La valoración precoz fue IBR en 16/16 pacientes de estadificación inicial (100%) y en 2/4 de recidiva (50%). Al final del tratamiento, en el primer grupo 14/16 pacientes con IBR consiguieron RMC y 1/16 RMP; 14 continuaron SEE y uno recidivó. En el segundo grupo 2/2 pacientes con IBR consiguieron RMC; uno continuó SEE y otro recidivó. Conclusion. La PET-TC tras los primeros ciclos de quimioterapia es útil para monitorizar el tratamiento debido a su elevado valor predictivo negativo (87,5%), modificando la terapia precozmente en los no respondedores(AU)

Objective. To assess the role of FDG-PET/CT performed after the first cycles of chemotherapy in the prediction of response to treatment in patients with diffuse large B-cell lymphoma. Methods. Twenty patients (mean age: 48 years) were included, 16 initial staging and 4 relapse. All patients underwent PET/CT at 3 times: 1) Baseline, 2) After 1-3 cycles of chemotherapy (early response assessment), and 3) End of treatment (evaluation of final response). Early PET/CT findings were correlated to the end-treatment PET/CT and follow-up. The evaluation of the response was established according to the decrease in uptake of the lesions (SUVmax). In the early assessment, a good response indicator (GRI) was obtained when the lesion disappeared or had more than 50% reduction in SUVmax. At the end of the treatment, a complete metabolic response (CMR) was determined in negative PET scans. Follow-up was superior to 19 months and final outcome was established as progression/relapse or no evidence of disease (NED). Results. At the early treatment evaluation, 16/16 patients of initial staging (100%) and 2/4 of relapse (50%) achieved GRI. At the end of treatment evaluation, 14/16 patients of initial staging with GRI achieved CMR and 1/16 PMR: 14 were alive with NED in the follow-up while 1 relapsed. In the second group, 2/2 patients with GRI achieved CMR (100%): 1 continued with NED in the follow-up and another relapsed. Conclusion. FDG-PET/CT after the first cycles of chemotherapy is useful to monitor treatment due to its high negative predictive value (87.5%), using it to modify treatment early in the non-responders(AU)

Utility of the PET-CT in the evaluation of early response to treatment in the diffuse large B-cell lymphoma. Preliminary results.

OBJECTIVE: To assess the role of FDG-PET/CT performed after the first cycles of chemotherapy in the prediction of response to treatment in patients with diffuse large B-cell lymphoma. METHODS: Twenty patients (mean age: 48 years) were included, 16 initial staging and 4 relapse. All patients underwent PET/CT at 3 times: 1) Baseline, 2) After 1-3 cycles of chemotherapy (early response assessment), and 3) End of treatment (evaluation of final response). Early PET/CT findings were correlated to the end-treatment PET/CT and follow-up. The evaluation of the response was established according to the decrease in uptake of the lesions (SUVmax). In the early assessment, a good response indicator (GRI) was obtained when the lesion disappeared or had more than 50% reduction in SUVmax. At the end of the treatment, a complete metabolic response (CMR) was determined in negative PET scans. Follow-up was superior to 19 months and final outcome was established as progression/relapse or no evidence of disease (NED). RESULTS: At the early treatment evaluation, 16/16 patients of initial staging (100%) and 2/4 of relapse (50%) achieved GRI. At the end of treatment evaluation, 14/16 patients of initial staging with GRI achieved CMR and 1/16 PMR: 14 were alive with NED in the follow-up while 1 relapsed. In the second group, 2/2 patients with GRI achieved CMR (100%): 1 continued with NED in the follow-up and another relapsed. CONCLUSION: FDG-PET/CT after the first cycles of chemotherapy is useful to monitor treatment due to its high negative predictive value (87.5%), using it to modify treatment early in the non-responders.