Modified Lengthening Temporalis Myoplasty Using an Intraoral Approach.

BACKGROUND: Lengthening temporalis myoplasty (LTM) is a unique and definite facial reanimation procedure that involves inserting the whole temporal tendon directly into the nasolabial fold. However, the nasolabial fold incision remains one of the difficulties of this procedure, particularly in young or female patient. To avoid the need for this incision, the authors developed an intraoral approach to manipulate the temporal muscle tendon toward the nasolabial fold. in this study, we describe the details of this procedure. METHOD: The authors performed their intraoral approach procedure in 5 patients with established complete facial paralysis. instead of making an incision at the nasolabial fold to approach the coronoid process, the authors made the incision at the buccal mucosa. The results were evaluated both subjectively and objectively. RESULTS: The authors achieved facial reanimation without leaving any obvious scar on the face or neck and the effect of static reconstruction is obvious, even immediately after the surgery. All the patients obtained good facial movement within 4 months (2.5 months in average), and improved all evaluated parameters postoperatively. No infections or other major complications were reported following surgery; however, 1 patient developed a slight dimple that required revision. DISCUSSION: The authors could advance temporal tendon toward nasolabial fold firmly obtaining sufficient surgical field similar to that of nasolabial fold incision, and achieved fairly good results without an obvious scar on the face.Establishing LTM without nasolabial fold incision, we could expand the indication of LTM more widely, and it could be more familiar procedure for smile reanimation in all generation.

Sliding Flap for the Wide Upper Eyelid Margin Defect After Cancer Removal.

BACKGROUND: Reconstruction of eyelid margin defects following resection of upper-eyelid skin malignancies is typically performed using a lower eyelid switch flap, including eyelash reconstruction. However, a subsequent procedure for flap separation, and prolonged swelling of the flap may occur as a complication. OBJECTIVE: The authors performed anterior lamellar reconstruction using a sliding flap with excess upper eyelid skin, a procedure that is a less invasive and simpler. MATERIALS AND METHODS: The authors performed anterior lamellar reconstruction using a sliding flap in 7 patients with full-thickness upper eyelid margin defect after skin cancer resection. The mean age of the patients was 76.0 years. The horizontal width of the defect in our cohort ranged from 11 to 25 mm and the vertical width ranged from 5 to 10 mm. RESULTS: All the flaps and mucosal grafts were well taken, and none of the patients complained of lack of eyelash reconstruction. However, eyelid margin irregularity, possibly due to flap or mucosal graft contraction, was observed in 2 patients, and 1 patient developed keratoconjunctivitis. CONCLUSIONS: The sliding flap technique is a minimally invasive and simple procedure for wide eyelid margin reconstruction. However, 2 patients developed eyelid margin irregularities and 1 patient developed keratoconjunctivitis. Those complications might have occurred owing to the condition of posterior lamellar reconstruction. Therefore, for the successful use of a sliding flap for anterior lamellar reconstruction, the form of the eyelid edge and the choice of posterior lamellar reconstruction are key considerations. In future, we plan to establish a better reconstructive technique by accumulating more evidence.

Adenoid Cystic Carcinoma Developed from the Parotid Gland to the Ear Lobe of a Young Woman.

Adenoid cystic carcinoma (ACC) is a relatively rare malignant tumor. It is more common in women than in men and typically develops in the lacrimal, salivary, and breast glands. ACC of the external auditory canal (EAC) is exceedingly rare, and its invasion into the ear lobe is even more unusual. In this report, we present a case of ACC that presented as a mass on the surface of the ear lobe in a 28-year-old woman and was initially diagnosed as infected atheroma. For wide resection of the tumor, half of the entire auricula was resected and superficial parotidectomy was performed. After confirming no tumor cells on the surface of the facial nerve, the defect was reconstructed by the combination of platysma muscle flap to prevent Frey syndrome and free forearm flap for the ear lobe form. There was no recurrence or metastasis of the tumor, and Frey syndrome did not occur at 2 years and 8 months after surgery. The patient was satisfied with the result, oncologically and cosmetically. Even in young patients, comprehensive treatments (including diagnosis, resection, and reconstruction) are important in painful ear lobe masses.

Speech Discrimination in Real-World Group Communication Using Audio-Motion Multimodal Sensing.

Speech discrimination that determines whether a participant is speaking at a given moment is essential in investigating human verbal communication. Specifically, in dynamic real-world situations where multiple people participate in, and form, groups in the same space, simultaneous speakers render speech discrimination that is solely based on audio sensing difficult. In this study, we focused on physical activity during speech, and hypothesized that combining audio and physical motion data acquired by wearable sensors can improve speech discrimination. Thus, utterance and physical activity data of students in a university participatory class were recorded, using smartphones worn around their neck. First, we tested the temporal relationship between manually identified utterances and physical motions and confirmed that physical activities in wide-frequency ranges co-occurred with utterances. Second, we trained and tested classifiers for each participant and found a higher performance with the audio-motion classifier (average accuracy 92.2%) than both the audio-only (80.4%) and motion-only (87.8%) classifiers. Finally, we tested inter-individual classification and obtained a higher performance with the audio-motion combined classifier (83.2%) than the audio-only (67.7%) and motion-only (71.9%) classifiers. These results show that audio-motion multimodal sensing using widely available smartphones can provide effective utterance discrimination in dynamic group communications.

Eicosapentaenoic Acid Improves Cisplatin-Induced Muscle Atrophy Without Accompanying Body Weight Gain.

INTRODUCTION: Cisplatin (CDDP) induces loss of muscle mass by activating the nuclear factor (NF)-κB signaling pathway. In this study, we investigated the effects of eicosapentaenoic acid (EPA), which inhibits NF-κB activation, on CDDP-induced loss of muscle mass in mice. METHODS: Male C57BL/6J mice received a single dose of CDDP and olive oil, linseed oil, or EPA daily for 4 days. Body weight and food intake were recorded daily for 5 days. Forelimb grip strength was determined using a strain gauge on the fourth day. The mice were killed 24 h after the final dose of fatty acid and the wet weight of their gastrocnemius, soleus, and tibialis anterior muscles measured. RESULTS: Olive oil, linseed oil, and EPA all failed to prevent decrease in food intake and loss of body weight. However, only EPA prevented loss of muscle mass and strength. CONCLUSION: EPA prevents CDDP-related loss of muscle mass and muscle but not CDDP-related loss of body weight.

The Difference in Backscatter Factors of Diagnostic X-rays by the Difference in the Scattering Medium and in the Objective Dose.

The diagnostic reference levels (DRLs) of the general X-ray radiography are defined by the absorbed dose of air at the entrance surface with backscattered radiation from a scattering medium. Generally, the entrance surface dose of the general X-ray radiography is calculated from measured air kerma of primary X-ray multiplied by a backscatter factor (BSF). However, the BSF data employed at present used water for scattering medium, and was calculated based on the water-absorbed dose by incident primary photons and backscattered photons from the scattering medium. In the calculation of air dose at the entrance surface defined in DRLs, there are no theoretical consistencies for using BSF based on water dose, and this may be a cause of calculation error. In this paper, we verified the difference in BSF by the difference in the scattering medium and by the difference in the objective dose by means of the Monte Carlo simulation. In this calculation, the scattering medium was set as water and the soft-tissue, and the objective dose was set as air dose, water dose, soft-tissue dose, and skin dose. The difference in BSF calculated by the respective combination was at most about 1.3% and was less than 1% in most cases. In conclusion, even if the entrance surface dose defined by DRLs of general X-ray radiography is calculated using BSF, which set both the scattering medium and the object substance of the absorbed dose as water, a so big error doesn't show.