Laryngochondroplasty: A Systematic Review of Safety, Satisfaction, and Surgical Techniques.

BACKGROUND: Since first performed in 1975, two main surgical techniques for laryngochondroplasty have evolved: anatomical localization and direct endoscopic visualization. The aim of this study was to evaluate which method is safest and had the highest patient-reported satisfaction rates, and to determine whether these outcomes have changed over time. METHODS: A systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to find and analyze all medical publications related to laryngochondroplasty. Of these studies, patients who underwent laryngochondroplasty for gender-affirmation surgery were evaluated. Surgical and patient-reported outcomes were compared between different surgical techniques and between studies before and after the year 2010. RESULTS: A total of 226 patients have been reported to have undergone laryngochondroplasty for gender-affirmation surgery. Overall transient and long-term complication rates were 14% and 0%, respectively. A 97% satisfaction rate was reported overall. Endoscopic visualization techniques were associated with lower short-term complications (OR, 21.11; 95% CI, 7.56 to 58.93); there was no difference in long-term complications (OR, 7.81; 95% CI, 0.31 to 194.37) or patient satisfaction (OR, 5.73; 95% CI, 0.32 to 101.97). Studies performed before the year 2010 had a significantly greater number of short-term complications compared to studies performed after the year 2010 (OR, 10.16; 95% CI, 3.71 to 27.82), with no difference in long-term complications (OR, 4.56; 95% CI, 0.18 to 113.25) or patient satisfaction (OR, 4.99; 95% CI, 0.59 to 42.20). CONCLUSIONS: All laryngochondroplasty techniques result in high patient satisfaction. Endoscopic visualization may help facilitate safe surgery and should be used in conjunction with anatomical familiarity. Technique choice should be dictated by the surgeon's experience and patient desires.

Burden of Pressure Injuries: Findings From the Global Burden of Disease Study.

Background: Pressure injuries remain among the most common problems faced by plastic surgeons and comprise a large portion of wound clinic practice. However, little is known about the overall morbidity related to the disease. This research sought to identify the burden related to the diagnosis of pressure injuries. Methods: We used the Global Burden of Disease Study 2017 to extract information about incidence and disability-adjusted life years (DALYs) related to pressure injuries from 1990 to 2017. Descriptive statistics were used to identify changes in the outcomes of interest. Results: A relative though not statistically significantly decrease in the incidence and burden of pressure injuries was observed between 1990 and 2017. Rates of incidence in the US appear higher than other higher socio-demographic index countries. No clinically and statistically significant changes were observed based on age or sex. Conclusions: Pressure injury incidence and burden have remained relatively stable between 1990 and 2017 with no significant improvement noted. There is room for improvement on a national performance level, and further research is needed regarding inconsistencies in regional outcomes.

Medical device related pressure ulcer of the lip in a patient with COVID-19: Case report and review of the literature.

Pressure ulcers of the lip constitute a rare entity faced by plastic surgeons and there is a relatively paucity of data regarding optimal management. In this study we present one case of upper lip pressure ulcer related to prone intubation for respiratory distress due to SARS-CoV-2 infection, treated with surgical excision and reconstruction. We also performed a review of the literature to identify other studies on pressure lip ulcers. Six studies were considered relevant. Conservative management constitutes the most common method of treatment; however, little is known about the aesthetic, and functional morbidity related to either surgical or non-surgical treatments.