Hyo-neck lift evolution: Neck lift with fixation of the platysma to the deep cervical fascia

Publication date: Available online 29 December 2017
Source:Annales de Chirurgie Plastique Esthétique
Author(s): C. Le Louarn
The aim of any neck lift obviously includes the restoration of an acute cervicomandibular angle. The hyo neck lift, first published in April 2016, did proposed a new technique of neck lift with a sub-cutaneous neck dissection and suture of the platysma to the hyoid through this sub-cutaneous approach. To enhance results and efficiency, a major change of the hyo neck lift technique is herein proposed with a vertical anterior sub-platysmal and sub-platysmal fat opening and dissection. This anterior dissection ensures a precise and efficient fixation of the platysma to the deep cervical fascia on direct visual control. This permits to create an horizontal and posterior vector of tension on both platysma and skin, which induces flattening of the submental area and consequently creates or recreates an acute cervicomandibular angle. The sub-cutaneous dissection is no more necessary at the hyoid level. In addition, the posterior border of the anterior platysmal flap is suspended to the mastoid fascia. If necessary, the submandibular gland, through this lateral approach, can be partially excised inside it's capsule, after strong bipolar coagulation. A botulinum toxin injection, realized in early post-op, will definitively stabilize the platysma to deep cervical fascia fixation. Fifteen patients underwent the new technique of neck lift with fixation of the platysma to the deep cervical fascia and suspension of the lateral platysma (Platysma Fixation Platysma Suspension: PF PS) and were evaluated at one year post-op and compared to the results obtained with the first preliminary prospective study "hyo neck lift technique" published in April 2016. As now subcutaneous dissection is limited, recovery is faster. No transient nerve damage happened because dissection planes are designed to be far from nerve branches.ConclusionsThe simplest way to obtain an acute cervicomandibular angle is to reattach the platysma to the deep cervical fascia along the platysma cords. The new neck lift with fixation of the anterior platysma to the deep cervical fascia and suspension of the lateral platysma, is faster to perform, induces a faster recovery and is safer and more efficient than the subcutaneous hyo neck lift and other described types of anterior platysma plasties.



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The effect of flurbiprofen oral spray and ibuprofen versus ibuprofen alone on postoperative tonsillectomy pain: an open randomised controlled trial

Abstract

Objective

This prospective clinical study was carried out to evaluate the analgesic efficacy and safety of oral spray form of flurpiprofen in the treatment of postoperative pain in tonsillectomy patients.

Study Design

Open randomised controlled clinical study.

Setting

Tertiary care training and research hospital.

Participants

One hundred (53 males, 47 females) with an age range of 18-53 years old (mean 27.4 ± 9.3 SD) undergoing tonsillectomy were enrolled to this prospective controlled study.

Main outcome measures

Patients receiving oral ibuprofen and flurbiprofen as spray form were enrolled as study group (53) whereas patients receiving only oral ibuprofen were enrolled as control group (47) in postoperative period. Postoperative pain was evaluated through visual analog scale on 12th hour, first, third and seventh days after surgery.

Results

The mean maximal pain score of patients who have received flurbiprofen spray and ibuprofen was 3.36 ± 1.93 SD that was statistically lower than the mean maximal pain score of patients who were medicated with only ibuprofen which was 4.06 ± 1.29 SD on postoperative seventh day (p=0.013).

Conclusion

This study revealed that addition of flurbiprofen spray to oral ibuprofen is effective in the management of postoperative pain in tonsillectomy patients with no notable complications.

This article is protected by copyright. All rights reserved.

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Cold/Cold vs. Bipolar Dissection Tonsillectomy: A Surgeon-Controlled Study of 400 Cases

Abstract

Surgeon controlled study of 200 cold/cold and 200 hot/hot tonsillectomy cases in one institution

Hot/hot resulted in higher overall rates of early and late post-tonsillectomy haemorrhage and return-to-theatre when compared to cold/cold methods.

Bipolar diathermy tonsillectomy resulted in a statistically significant higher rate of secondary post-tonsillectomy haemorrhage than cold-steel of nearly three times.

Trainee surgeons performed better in bipolar haemostasis than cold-steel dissection with regard to post-operative morbidity.

With continued use of cold-steel tonsillectomy methods in both junior and senior surgeons, it is hoped that the rates of PTH and RTT will continue to improve.

This article is protected by copyright. All rights reserved.

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Double Suspension Sutures: a simple Surgical Technique for Selected Cases of obstructive Sleep Apnea: our experience with twenty two patients

Abstract

This work aimed at presenting a simple modification of expansion pharyngoplasty using bilateral double palatal suspension sutures for the treatment of selected cases of snoring and OSA.

Between Marsh 2013 and August 2017, twenty- two patients underwent the double suspension sutures technique as a treatment for retropalatal collapse of obstructive sleep apnea.

Postoperatively, the mean AHI and the mean lowest oxygen saturation level showed highly significant improvement. Both the retropalatal and interpillar distances were increased significantly.

No persistent postoperative complications were reported. Snoring disappeared in 86.4% of patients.

The procedure is simple, well-tolerated by patients and reversible. It is an economic and less traumatic maneuver. It could be applied as a part of multilevel surgery.

This article is protected by copyright. All rights reserved.

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The effect of flurbiprofen oral spray and ibuprofen versus ibuprofen alone on postoperative tonsillectomy pain: an open randomised controlled trial

Abstract

Objective

This prospective clinical study was carried out to evaluate the analgesic efficacy and safety of oral spray form of flurpiprofen in the treatment of postoperative pain in tonsillectomy patients.

Study Design

Open randomised controlled clinical study.

Setting

Tertiary care training and research hospital.

Participants

One hundred (53 males, 47 females) with an age range of 18-53 years old (mean 27.4 ± 9.3 SD) undergoing tonsillectomy were enrolled to this prospective controlled study.

Main outcome measures

Patients receiving oral ibuprofen and flurbiprofen as spray form were enrolled as study group (53) whereas patients receiving only oral ibuprofen were enrolled as control group (47) in postoperative period. Postoperative pain was evaluated through visual analog scale on 12th hour, first, third and seventh days after surgery.

Results

The mean maximal pain score of patients who have received flurbiprofen spray and ibuprofen was 3.36 ± 1.93 SD that was statistically lower than the mean maximal pain score of patients who were medicated with only ibuprofen which was 4.06 ± 1.29 SD on postoperative seventh day (p=0.013).

Conclusion

This study revealed that addition of flurbiprofen spray to oral ibuprofen is effective in the management of postoperative pain in tonsillectomy patients with no notable complications.

This article is protected by copyright. All rights reserved.

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via IFTTT

Cold/Cold vs. Bipolar Dissection Tonsillectomy: A Surgeon-Controlled Study of 400 Cases

Abstract

Surgeon controlled study of 200 cold/cold and 200 hot/hot tonsillectomy cases in one institution

Hot/hot resulted in higher overall rates of early and late post-tonsillectomy haemorrhage and return-to-theatre when compared to cold/cold methods.

Bipolar diathermy tonsillectomy resulted in a statistically significant higher rate of secondary post-tonsillectomy haemorrhage than cold-steel of nearly three times.

Trainee surgeons performed better in bipolar haemostasis than cold-steel dissection with regard to post-operative morbidity.

With continued use of cold-steel tonsillectomy methods in both junior and senior surgeons, it is hoped that the rates of PTH and RTT will continue to improve.

This article is protected by copyright. All rights reserved.

from #ORL via a.lsfakia on Inoreader http://ift.tt/2lt3mMU
via IFTTT

Double Suspension Sutures: a simple Surgical Technique for Selected Cases of obstructive Sleep Apnea: our experience with twenty two patients

Abstract

This work aimed at presenting a simple modification of expansion pharyngoplasty using bilateral double palatal suspension sutures for the treatment of selected cases of snoring and OSA.

Between Marsh 2013 and August 2017, twenty- two patients underwent the double suspension sutures technique as a treatment for retropalatal collapse of obstructive sleep apnea.

Postoperatively, the mean AHI and the mean lowest oxygen saturation level showed highly significant improvement. Both the retropalatal and interpillar distances were increased significantly.

No persistent postoperative complications were reported. Snoring disappeared in 86.4% of patients.

The procedure is simple, well-tolerated by patients and reversible. It is an economic and less traumatic maneuver. It could be applied as a part of multilevel surgery.

This article is protected by copyright. All rights reserved.

from #ORL via a.lsfakia on Inoreader http://ift.tt/2lndKGN
via IFTTT