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Accessory columellas are rare congenital anomalies characterized by skin appendage in the columella of the nostril. Case reports are scattered, but there are few descriptions about the clinical features and surgical course.

In this study, 3 patients with 4 lesions were identified (2013-2020). They were morphologically classified, and the accompanying nose deformity, surgical procedure, and postoperative course were examined.

According to the morphologic classification, 1 lesion was of the sessile-lobed type, 2 lesions were of the sessile-nodular type, and 1 lesion was of the pedunculated-ovoid type. In terms of accompanying nose deformities, 1 lesion had a wide nasal columella, and 1 lesion had an enlarged left nostril due to a depression at the base of the lesion. Simple ablations were performed in 2 of the lesions, and plastic procedures were performed in the 2 lesions with an accompanying nose deformity.

As in our cases, accessory columellas may have a variety of appearances and accompanying deformities. The surgical procedure must be considered according to the case. In addition, any changes due to growth must be observed and taken into consideration when they are reoperated.

As in our cases, accessory columellas may have a variety of appearances and accompanying deformities. The surgical procedure must be considered according to the case. In addition, any changes due to growth must be observed and taken into consideration when they are reoperated.Breast reduction is one of the most commonly requested and performed plastic surgery procedures, and its psychological, esthetic, and analgesic benefits are well known. Several studies dealing with the effects of reduction mammoplasty on the physiology of respiration have been published in the past decades. This systematic review aims to assess whether bilateral breast reduction is associated with measurable improvement in lung function in women with macromastia. This review was performed in accordance with the PRISMA guidelines. PubMed, SCOPUS, and Web of Science databases were queried in search of clinical studies that investigated lung function in women undergoing breast reduction for macromastia and reported any type of parameter or outcome measure relevant to pulmonary function. The search yielded 394 articles of which 15 articles met our specific inclusion criteria. The primary outcome measures of the studies and their respective results were tabulated, contrasted, and compared. The 15 studies included in this review cover the period from 1974 to 2018. According to most included studies, reduction mammaplasty produces a change of objective respiratory parameters, such as spirometric tests or arterial blood gas (ABG) measurements; nevertheless, the clinical and functional relevance of the observed changes is debatable.

Esophageal cancer is the most common second primary cancer (SPC) in patients with head and neck cancer (HNC). Esophageal SPC has a negative impact on survival. learn more Elevated mean corpuscular volume (MCV) is an accepted predictor of esophageal cancer risk. The aim of this study was to elucidate the usefulness of elevated MCV as an indicator of a high risk for esophageal SPC.

We retrospectively reviewed the medical records of patients with oropharyngeal, hypopharyngeal, and laryngeal squamous cell carcinoma who underwent chemoradiotherapy between 2003 and 2012. We excluded patients younger than 20 years or who had received treatment for esophageal cancer and who had a histologically unproven lesion. Patients were divided into two groups according to their MCV. The cut-off for MCV was defined by receiver operating characteristics curve analysis. The primary endpoint was the cumulative incidence of esophageal SPC.

A total of 295 patients were included. The median follow-up period for surviving patients was 7.4 years and the optimal cut-off point was 99.0 fL. One hundred ninety-five patients (66%) had an MCV < 99.0 fL and 100 (34%) had an MCV ≥ 99.0 fL. The 5-year cumulative incidence in patients with an MCV < 99.0 fL and ≥ 99.0 fL was 8.7% and 27%, respectively. In the multivariate analysis, an MCV ≥ 99.0 fL (HR=2.2; 95%CI, 1.1-4.2) was an independent risk factor.

MCV ≥ 99.0 fL was found to be a risk factor for esophageal SPC. We, therefore, recommend that patients with an MCV ≥ 99.0 fL should undergo intensive monitoring.

MCV ≥ 99.0 fL was found to be a risk factor for esophageal SPC. We, therefore, recommend that patients with an MCV ≥ 99.0 fL should undergo intensive monitoring.There are previous papers suggesting that floor of mouth (FOM) oral squamous cell carcinomas (OSCC) metastasise earlier than other oral cavity subsites. This report further evaluates that hypothesis. Between February 2006 and December 2019, 825 patients underwent curative resection of OSCC. Data on nodal metastases and depth of invasion (DOI) of the primary tumour were collated. The relationship between tumour DOI and likelihood of nodal metastases was examined. A total of 203 patients had a FOM OSCC, 75 of which had nodal metastases. No difference was found in the incidence of, or correlation with DOI, and occurrence of regional metastases when FOM was compared to other OSCC subsites. We conclude that FOM OSCC has a similar regional metastatic propensity as other subsites in the oral cavity.

Comminuted radial head fractures are commonly treated by surgical resection or replacement with a prosthesis. A potential problem with radial head replacement is overlengthening of the radial neck ("overstuffing" of the radial head), which has been shown to affect both ulnohumeral kinematics and radiocapitellar pressures. We hypothesized that an overstuffed radial head prosthesis increases capitellar pressure and reduces coronoid pressure.

Seven human cadaveric elbows were prepared on a custom-designed apparatus simulating stabilizing muscle loads, and passively flexed from 0° to 90° under gravity valgus torque while joint contact pressures were measured. Each elbow was tested sequentially with different neck lengths, starting with the intact specimen followed by insertion of understuffed (-2 mm), standard-height (0 mm), and overstuffed (+2 mm) radial head prostheses in neutral forearm rotation, 40° pronation, and 40° supination positions, respectively.

Capitellar mean contact pressures significantly inis critical when performing radial head arthroplasty to maintain normal joint biomechanics. Elevated capitellar contact pressures can potentially lead to pain and early degenerative changes.

Currently, no literature specifically addresses the curative efficacy of laparoscopic duodenum-preserving total pancreatic head resection (LDPPHRt) in the treatment of pancreatic-head intraductal papillary mucinous neoplasm (IPMN). This study aimed to compare the short-term and long-term outcomes between LDPPHRt and laparoscopic pancreaticoduodenectomy (LPD) for pancreatic-head IPMN.

We retrospectively reviewed patients undergoing LDPPHRt or LPD for pancreatic-head IPMN in our institution between September 2014 and October 2020. We collected, analyzed and compared preoperative, intraoperative, and perioperative data, including quality of life as assessed using EORTC QLQ-C30 and QLQ-PAN26 questionnaires.

In total, 50 patients were incorporated into this study, which included 12 LDPPHRt patients and 38 LPD patients. Preoperative data was comparable in the two groups, and neither was there any significant difference in postoperative data. The incidence of exocrine and endocrine insufficiency was similar between the LDPPHRt and LPD groups (50% vs. 28.9%, p=0.321; 8.3% vs. 7.9%, p=1.000), but some differences between the two surgical procedures were apparent when evaluating postoperative quality of life. Specifically, patients in the LDPPHRt group reported higher physical functional and body image scores than the LPD group (96.1±6.0 vs. 88.2±13.9, p=0.008; 65.3±32.9 vs. 43.0±31.4, p=0.039), and LDPPHRt was also associated with lower digestive symptom scores (5.5±12.9 vs. 28.9±25.9, p=0.004).

Perioperative outcomes for LDPPHRt were comparable to those for LPD, but the quality of life after operation was better in the LDPPHRt group.

Perioperative outcomes for LDPPHRt were comparable to those for LPD, but the quality of life after operation was better in the LDPPHRt group.

This study aimed to identify the risk factors for permanent stoma (PS) in patients who underwent sphincter-saving operations for rectal cancer.

We retrospectively reviewed 597 consecutive patients with rectal cancer from January 2012 to December 2020at Taipei Medical University Hospital. Univariate and multivariable analyses were used to analyze risk factors for PS.

After a mean follow-up of 47.3 months (range 7-114 months), 59 patients (15.1%) were alive with a PS, including 46 patients who did not undergo reversal surgery and 13 patients who underwent stoma re-creation after reversal surgery. The mean period between primary surgery and stoma reversal was 6.0 months. Multivariate analysis revealed that the risk factors for PS were local recurrence [odd ratio (OR), 25.58; 95% confidence interval (CI), 4.428-147.761; p<0.001], perirectal abscess [OR, 154.34; 95% CI, 15.806 - >999; p<0.001], anastomosis site stenosis [OR, 187.081; 95% CI, 22.193 - >999; p<0.001], perineural invasion [OR, 4.782; 95% CI, 1.22-18.736; p=0.025], and operation time (min) [OR, 1.008; 95% CI, 1.002-1.014; p=0.01].

Local recurrence, perirectal abscess, anastomosis site stenosis, perineural invasion, and operation time were independent risk factors for PS. Therefore, before a patient undergoes surgery for rectal cancer, surgeons should consider the possibility of the need for a PS, and patients should be informed before the operation that closure of the temporary stoma may not always be possible.

Local recurrence, perirectal abscess, anastomosis site stenosis, perineural invasion, and operation time were independent risk factors for PS. Therefore, before a patient undergoes surgery for rectal cancer, surgeons should consider the possibility of the need for a PS, and patients should be informed before the operation that closure of the temporary stoma may not always be possible.

Acute gallbladder perforation is a rare complication of biliary diseases with an estimated incidence of 2% of all gallbladder diseases. It carries a higher risk of morbidity and mortality. This study examines the risk factors and outcome of patients admitted with acute and subacute gallbladder perforation (AGBP) to a tertiary hospital in the Eastern Province of Saudi Arabia.

A retrospective study was performed including all patients with biliary diseases who were operated on from Jan. 2016 until Dec. 2020. The patients were divided the first group included patients with AGBP and the second group included patients with other biliary diagnoses. We excluded patients with chronic perforation, traumatic or malignant perforation.

A total of 587 patients were eligible for this study. The incidence of AGBP was 2.7% and its morbidity was 6.3% with no mortality reported. AGBP was significantly associated with male gender, older age, in patients with two or more associated comorbidities; diabetes mellitus, hypertension and dyslipidemia.