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Honorary Editor-in-Chief of AOHNS: Dr. Murray Grossan

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A Rare Case of High-Grade Non-intestinal Sinonasal Adenocarcinoma

A Rare Case of High-Grade Non-intestinal Sinonasal Adenocarcinoma

The incidence of high-grade sinonasal adenocarcinomas of non-intestinal origin is extremely rare. In this case report, the authors present a very rare case of high-grade non-intestinal sinonasal adenocarcinoma presenting with a challenging diagnosis. Because of its significantly different prognosis, this study provides a detailed explanation of how the authors differentiate it from other sinonasal tumors. In addition, they describe how a radical endoscopic resection was applied in order to achieve a total excision.
Penopubic Junction Reconstruction Using a Pedicled Superficial Circumflex Iliac Artery Perforator Flap

Penopubic Junction Reconstruction Using a Pedicled Superficial Circumflex Iliac Artery Perforator Flap

The article describes the case of a 27-year-old man who suffered from scarring at the penopubic junction as a result of penis lengthening surgery. The authors explain how they repaired the penopubic junction by using a pedicled superficial circumflex iliac artery perforator flap. The authors also propose a safe and effective hybrid technique for harvesting superficial circumflex iliac artery perforator flaps. According to the authors, the pedicled superficial circumflex iliac artery perforator flap is an effective method for reconstructing the penopubic scar.
Postoperative Monitoring of Free Flaps Using Smartphone Thermal Imaging May Lead to Ambiguous Results: Three Case Reports

Postoperative Monitoring of Free Flaps Using Smartphone Thermal Imaging May Lead to Ambiguous Results: Three Case Reports

Smartphones and cellular technology have revolutionized flap monitoring. Smartphones provide low-cost thermal imaging alternatives to flap monitoring. It remains unclear, however, whether this method is accurate or reliable. It may be challenging to use smartphone thermal imaging when clinicians fail to communicate clinically relevant events. The authors demonstrate three instances in which the thermal imaging information on smartphones was misleading. Each case is analyzed to determine how clinical decisions should be made.
A Simple and Innovative Technique to Offload the Microsurgical Loupe

A Simple and Innovative Technique to Offload the Microsurgical Loupe

The loupe plays a critical role in the microsurgeon's arsenal, helping to provide intricate details. In the absence of adequate subcutaneous fat, the prismatic lens of the spectacle model may exert enormous pressure on the delicate skin of the nasal bone. By developing a soft nasal support, the author has incorporated the principle of offloading into an elegant, simple yet brilliant innovation. A simple procedure such as this could prove invaluable for microsurgeons who suffer from nasal discoloration or pain as a result of prolonged use of prismatic loupes. With this technique, 42% of the pressure applied to the nose is reduced.
An Innovative Model for Microsurgical Training at a Spine Surgery Center in Mexico City

An Innovative Model for Microsurgical Training at a Spine Surgery Center in Mexico City

In a cost-effective and portable way, a novel method was developed to assist trainees in spinal surgery to gain and develop microsurgery skills, which will increase self-confidence. Residents at a spine surgery center were assessed before and after training on the effectiveness of a simulation training model. The participants who used the training model completed the exercise in less than 22 minutes, but none could do it in less than 30 minutes previously. The research team created a comprehensive model to train junior surgeons advanced spine microsurgery skills. The article contains valuable information for readers.
Plugging of a Dehiscent Superior Semicircular Canal Damages the Spiral Ganglion Regardless of the Material Used

Plugging of a Dehiscent Superior Semicircular Canal Damages the Spiral Ganglion Regardless of the Material Used

The purpose of this study is to investigate the potential damage to the cochlea caused by plugging a dehiscent superior semicircular canal with different plugging materials in a histological animal study (gerbils). The authors assessed the extent of damage to the cochlea by measuring the number, size, and density of spiral ganglion neurons as well as the size of Rosenthal
World

World's Top 2% Scientists in AOHNS

Our Editor-in-Chief Dr. Holger Sudhoff and Deputy Editor Dr. Chin-Lung Kuo of AOHNS were recognized in the list of the World's Top 2% Scientists published by the prestigious Stanford University. The SciTeMed Publishing group would like to congratulate Dr. Holger Sudhoff and Dr. Chin-Lung Kuo for this honor that has brought great pride to our publisher.

A Full Waiver of Any Submission of Original or Review Article to International Microsurgery Journal (IMJ) from Sep. 4, 2021 to Oct. 31, 2018!

A Full Waiver of Any Submission of Original or Review Article to International Microsurgery Journal (IMJ) from Sep. 4, 2021 to Oct. 31, 2018!

To celebrate nearly 5 years of partnership with International Microsurgery Club, we are waiving the publication fee (USD 790) for any submission of original article or review article to International Microsurgery Journal. This offer ends on Oct. 31, 2021. Join us today!
Effective Management of Epistaxis

Effective Management of Epistaxis

There have been several developments in the management of epistaxis. In this article, the author has reviewed the literature on epistaxis, its anatomy, etiology, and the current developments in its treatment. The stepwise treatment algorithms and flow diagram provided in the article will guide the clinicians to produce better results in epistaxis management.

Muscle Relaxant Administration to Manage Severe Tracheomalacia

Muscle Relaxant Administration to Manage Severe Tracheomalacia

Tracheomalacia is a rare congenital abnormality of the tracheobronchial cartilage causing the collapse of the airway and obstruction of expiratory flow. It is very difficult to manage infants with severe tracheomalacia. Severe cases lead to worse respiratory conditions and may become life-threatening, and necessitate immediate surgical treatment. Takeshi Yano of the University of Miyazaki, Japan has published an article in the Annals of Case Reports and Images Journal, in which a method to manage severe tracheomalacia patients using muscle relaxant has been discussed.

Relationship between Depression and Cholesteatoma

Relationship between Depression and Cholesteatoma

The study by Dr. Chin-Lung Kuo provided strong evidence, which was unrecognized earlier, to establish the potential link between cholesteatoma and depression. It is necessary to conduct routine psychiatric screening and monitoring of cholesteatoma patients for detection and treatment at the beginning stage itself. Despite the accuracy and acceptability of this population-based study, more prospective studies need to be carried out for additional confirmation.

Safety Science Principles for Administration of Oxytocin and Magnesium Sulfate in Labor & Delivery Units

Safety Science Principles for Administration of Oxytocin and Magnesium Sulfate in Labor & Delivery Units

The Institute of Safe Medication Practices has listed Oxytocin and Magnesium sulfate as high-alert medications causing significant harm to patients when used in error. Since these medications are frequently used in Labor & Delivery (L&D) units, safe administration to prevent medication errors is necessary for these units. As a part of the Safety Program for Perinatal Care (SPPC) of the Agency for Healthcare Research and Quality (AHRQ), several L&D units opted for implementing safety science principles for the safe administration of oxytocin and magnesium sulfate. The research team led by Kayla B Gray has published a qualitative research article in the Research on Women’s Health Journal, which describes the experiences of 25 L&D units, which have opted to implement the safety science principles for the safe administration of these medications.

Conversations with SciTeMed Editors and Expert Mentors

Dr. Shyun-Jing Wee, the author of the article, entitled Penopubic Junction Reconstruction Using a Pedicled Superficial Circumflex Iliac Artery Perforator Flap, met with the editors at SciTeMed as well as expert mentors to discuss the research in order to maximize its impact and ensure its wide dissemination. The webinar was moderated by Dr. Laura Chia-Fang Chen, a surgeon at Linkou Chang Gung Memorial Hospital who specializes in plastic and reconstructive surgery.

Design and Harvest of the Thin Profunda Artery Perforator Flap

Here is a video that shows the harvest of a thin profunda artery perforator flap from the left thigh. In conjunction with preoperative computed tomography angiography, measurement of the morphology of the perforators and their branches, the pedicle length, and the vertical locations of the two branches from the ischial tuberosity are performed. A handheld doppler is used to confirm the location of both branches. As a result of the authors' results, preoperative computed tomography angiography is a valuable way of obtaining detailed anatomical information such as the shape of perforators, their path through the septum or muscle above the deep fascia, as well as the thickness of the skin. It is important to know that computed tomographic angiography is an excellent means of making an assessment of the entire vascular anatomy of the leg, and it results in making an informed decision about the choice of flaps, based on the patient's anatomy and the characteristics of the defect.

A Modified Technique of Mouse Vertical Sleeve Gastrectomy Using Two Disposable Micro-clamps

Vertical sleeve gastrectomy (VSG) is a type of bariatric surgery that is accepted as the simplest but most efficient surgical modality to treat morbid obesity. A mouse model of VSG has been widely utilized to investigate the underlying mechanisms of VSG. There are numerous microsurgical techniques for VSG in mice, and the authors report herein a modified technique with 2 disposable micro-clamps to simplify the surgery. The key aspects of the modification are to use the micro-clamps as non-crushing tissue clamps for anastomosis as well as vascular clamps for hemostasis. Mean body weight at postoperative week 1 was 24.1 grams, which is equivalent to a 16.1% loss of original body weight, and there was no mortality after antrum preservation VSG. This simplified surgical technique will best serve as a tool to investigate either the underlying mechanisms of VSG or the intrinsic change to the stomach after VSG.

An Innovative Method for the Training of Microsurgical Anastomosis Using a Silicone Tube

One of the aims of several reconstructive surgical procedures is to achieve a patent microvascular anastomosis. Developing clinical competency in this specialized skill requires intensive training on live animal models as a first step. The early training stage of microvascular anastomosis can be stressful for novices. This is because the rat vessels used in such training courses are usually too small and fragile for novices to maintain the vascular lumen in an optimal fashion. Throughout this paper, the authors discuss the use of a silicone tube to provide structural support to vessels throughout the entire precarious suturing process. Using this modified version of the conventional microvascular anastomosis technique may facilitate initial skill acquisition in the rat model.

Vascularized Lymph Vessel Transfer - Lymph Node Transfer 2.0?

Lymphaticovenular anastomosis (LVA) and vascularized lymph node transfer (VLNT) are established lymphedema treatments. However, LVA is only effective for early disease and VLNT can cause donor-site lymphedema and contour deformity. Vascularized lymph vessel transfer (VLVT) is free of these limitations. In the video, the authors described their experience of a new VLVT technique.

Laryngoscopic Examination for Signs of Laryngeal Irritation Associated With Reflux

This video shows a laryngoscopic examination for signs of laryngeal irritation associated with laryngopharyngeal reflux. Large bilateral granulomas are identified on the surface of bilateral arytenoids

Editor's Choice

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Peer Review for Academic Research

Peer Review for Academic Research

This article provides an overview of the major elements of a comprehensive manuscript review. The article also illustrates some of the basic responsibilities of the reviewer and describes some of the benefits and burdens associated with this role. Scholars may find this article useful as they conduct critical reviews of research papers.
Development of Tibial Osseo-Periosteal Flap for Complex Nonunions and Bone Defects

Development of Tibial Osseo-Periosteal Flap for Complex Nonunions and Bone Defects

The senior author (Dr. Isao Koshima) designed a tibial osseo-periosteal (TOP) flap. TOP flap has a favorable anatomical position with a thin skin around it, hence it is a good option for an island flap. TOP flap can be used for various mild to moderately sized osteo-cutaneous defects with low morbidity. In this article, the authors describe their experience of the first reported cohort of TOP flaps in clinical practice.
Illness Perceptions, Psychological Distress and Coping Strategies as Predictors of Quality of Life After Radiotherapy in Head and Neck Cancer Patients

Illness Perceptions, Psychological Distress and Coping Strategies as Predictors of Quality of Life After Radiotherapy in Head and Neck Cancer Patients

The study aims to assess the predictive values of certain psychological factors on the quality of life in patients with Head and Neck Cancer after radiotherapy. The authors conclude that the identification and the understanding of the depressive symptoms of patients, their beliefs about their illness as well as their coping strategies may provide the basis for timely implementation of appropriate intervention that may improve the quality of life in patients.
Dangers of a False Sense of Security in a Huge Mastoid Cholesteatoma With Skull Base Erosion and Cerebrospinal Fluid Leakage

Dangers of a False Sense of Security in a Huge Mastoid Cholesteatoma With Skull Base Erosion and Cerebrospinal Fluid Leakage

The author reports a case involving a 59-year-old man with delayed presentation of a huge mastoid cholesteatoma complicated by skull base erosion and cerebrospinal fluid leakage. Delayed presentation of this disease entity can have negative health consequences for patients. Regular otologic examinations, audiologic follow-up, and imaging examinations are viewed as the most effective strategies for the prevention of this type of situation. Early recognition of cholesteatomas is essential, as appropriate and timely treatment can prevent this rare comorbid condition from becoming fatal.
Voice, Cough, and Diurnal Breathing Problems and Quality of Life in Obstructive Sleep Apnea

Voice, Cough, and Diurnal Breathing Problems and Quality of Life in Obstructive Sleep Apnea

The study identifies how current voice, cough, and daytime breathing problems affect mental and physical quality of life in obstructive sleep apnea patients, as well as how the combination of voice, cough, and diurnal dyspnea impacts quality of life.
Neuroplastic Effect of Constraint-Induced Music Therapy on Hearing Recovery in Patients with Sudden Sensorineural Hearing Loss

Neuroplastic Effect of Constraint-Induced Music Therapy on Hearing Recovery in Patients with Sudden Sensorineural Hearing Loss

Constraint-induced music therapy has been shown to enhance hearing recovery in patients with sudden sensorineural hearing loss by preventing maladaptive reorganization of the auditory cortex. This study was the second research to provide scientific evidence related to the neuroplasticity of the central auditory nervous system in response to constraint-induced acoustic rehabilitation.
Head and Neck Juxtacortical Chondrosarcoma

Head and Neck Juxtacortical Chondrosarcoma

The incidence of Head and Neck Juxtacortical Chondrosarcoma (HNJCS) is extremely rare. Among a large database, the authors could identify only nine cases of HNJCS that have been amply described. It has been observed that irrespective of the location of the body, HNJCS has a consistent clinical and diagnostic profile. HNJCS is generally a low or intermediate grade malignancy with a low rate of recurrence and metastases. Primary surgical excision with negative margins was found to be the therapeutic modality of choice.  Radiotherapy and chemotherapy have limited roles in the management of HNJCS.

Assessment and Management of Laryngopharyngeal Reflux

Assessment and Management of Laryngopharyngeal Reflux

In this article, the author reviews the manifestations, diagnosis, and treatments of LPR and suggests adopting a multidisciplinary approach for a reliable and conclusive diagnosis of LPR. Based on the previous research and latest findings, an algorithm is put forth to streamline the assessment and management of reflux disorders. Highlighting the significance of correct diagnosis and effective treatment of LPR, the author suggests that in case the diagnosis is doubtful, and the therapeutic response is unsatisfactory, the patient should be referred to a specialist.

A Comparison of Hematology and Cytology Laboratories in Detection of Body Fluid Malignancy

A Comparison of Hematology and Cytology Laboratories in Detection of Body Fluid Malignancy

Based on the comparison between the hematology and cytology, the authors concluded that by improving the skills of the technologists of the hematology laboratory in identifying cell morphology, the diagnostic values in body fluid malignancy could be improved, and the hematology laboratory would achieve comparable competency similar to the cytology laboratory.

Can the Cervical Length Predict Procedure-Related Miscarriage?

Can the Cervical Length Predict Procedure-Related Miscarriage?

Procedure-related miscarriage is the most crucial complication of the prenatal invasive tests which are being used for the diagnosis of fetal aneuploidies. Even though several risk factors like operator experience, gestational age, sampling route, and the number of tapping have been suggested for the procedure-related miscarriage, the cause of this complication remains unknown. The results of the study confirmed that the cervical lengths in the patients complicated with miscarriages were within normal limits.

The Brain Functions Mathematically!

The Brain Functions Mathematically!

The brain can process information, store them, and retrieve them as and when required; however, we hardly know much about the physiological mechanisms behind such fundamental functions of the brain. The efforts by psychologists, scientists, engineers, physicists, and mathematicians over the past decades have given some significant insight on the brain functions and have been helpful for carrying out further research on the subject.

Welcome Prof. Isao Koushima as Honorary Editor-in-Chief in International Microsurgery Journal

Welcome Prof. Isao Koushima as Honorary Editor-in-Chief in International Microsurgery Journal

It is our pleasure to invite Prof. Isao Koushima to be Editor-in-Chief in International Microsurgery Journal!

Experience with Robotic-assisted Microsurgery

Over the past decade, Da Vinci Surgical System has made great strides in surgery. It has been widely applied in urology, gynecology, bariatric surgery, hepatobiliary surgery, thoracoscopic surgery, cardiac surgery, neurological surgery, and transoral otolaryngologic neoplasm resection. However, its application in plastic and reconstructive surgery still in the preliminary stages of development. I went to Hong Kong in April 2013 for the robotic surgical system training program and was awarded console surgeon certificate.

Chang's Technique of Sequential End-to-Side Microvascular Anastomosis

This novel technique of sequential ETS micro-venous anastomosis is a modified technique from its classical form. The unique use of vessel loops provides protection to the vessel, while it achieves equisegmental IJV occlusion for sequential (proximal to distal) venous anastomosis. This method not only saves precious operating time from repetitive positioning of instruments and recipient vessel (IJV), but also creates a safer operating field for the microsurgeons. Utilizing a second single vascular clamp over the anastomosis junction provides an anchoring point for self-retraction by revealing and maintaining an accessible position to the posterior wall, once it is turned at 180 degrees laterally. This maneuver allows the surgeon to have full control of the surgical field and perform ETS micro-venous anastomosis confidently and independently.

Lateral Plantar Artery as Recipient Vessel for Microsurgical Lateral Plantar Forefoot Reconstruction

Division of the lateral plantar artery does not jeopardize the foot circulation because of anastomosis of the lateral plantar artery with the dorsalis pedis artery at the first intermetatarsal space. However, care should be taken with patients with peripheral artery occlusive disease and the flow of dorsalis pedis artery should be confirmed before surgery. Given the advantages of sizable vessel, easy dissection, and proximity to the defect, we believe that the lateral plantar artery might be a valuable option as recipient vessel for lateral plantar forefoot reconstruction.

The Versatility of Pedicled Anterolateral Thigh Flap - A Tertiary Re-ferral Center Experience from India

Pedicled anterolateral thigh flap is a versatile option for reconstruction of complex soft tissue defects in varied anatomical regions. Its wide arc of rotation and less donor site morbidity are its added advantages.

A Great Opportunity to Meet and Learn from Peripheral Nerve Experts

The 2nd instructional course for adult brachial plexus injuries is a fantastic opportunity to meet and learn from experts in the field. We cordially invite you to visit Chang Gung Memorial Hospital to participate in this unique learning experience.

Interview with Dr. Murray Grossan, the Honorary Editor-in-Chief of AOHNS

An exciting conversation with Dr. Murray Grossan, the Honorary Editor-in-Chief of Archives of Otorhinolaryngology-Head & Neck Surgery (AOHNS). Dr. Murray Grossan talked about AOHNS’s new direction and the important means for communicating scientific work to complement teaching and training in the field of medicine.