April 2020 HSC Section 4 - Plastic and Reconstructive Problems

II. RECONSTRUCTION

A. Functional rhinoplasty Sidle DM, Stolovitzky P, Ow RA, et al. Twelve-month outcomes of a bioabsorbable implant for in- office treatment of dynamic nasal valve collapse. Laryngoscope . 2019 Jun 28. doi: 10.1002/lary.28151. [Epub ahead of print]. EBM level 2b..............................................................................................110-115 Summary : The authors performed a case series of 166 patients who were treated with a bioabsorbable nasal sidewall implant with or without concurrent inferior turbinate reduction. Twelve-month data demonstrates improvement in NOSE scores. The study is an update of a previous publication that demonstrated 6-month post-procedure data. Disclosure: some authors served as consultants and/or received research funding from Spirox, the parent company of Latera, prior to purchase by Stryker. Stolovitzky P, Senior B, Ow RA, et al. Assessment of bioabsorbable implant treatment for nasal valve collapse compared to a sham group: a randomized control trial. Int Forum Allergy Rhinol . 2019; 9(8):850-856. EBM level 1.............................................................................................................116-122 Summary : The authors performed a single-blinded, randomized sham-controlled trial of a bioabsorbable nasal sidewall implant to improve nasal airway obstruction secondary to nasal valve collapse. One- month and 3-month outcomes (NOSE and VAS) are provided, showing improvement in both arms, but greater improvement in the implant arm. Disclosure: some authors served as consultants and/or received research funding from Spirox, the parent company of Latera, prior to purchase by Stryker. B. Treatment of hypertrophic scars and keloids Khan FA, Drucker NA, Larson SD, et al. Pediatric earlobe keloids: outcomes and patterns of recurrence. J Pediatr Surg . 2019 Jul 24; doi: 10.1016/j.jpedsurg.2019.07.006. [Epub ahead of print]. EBM level 4.....................................................................................................................................123-126

Summary : This manuscript describes outcomes after treatment of pediatric keloids. This study has a 2-year follow-up and reports similar recurrence rates across all treatment modalities.

Siotos C, Uzosike AC, Hong H, et al. Keloid excision and adjuvant treatments: a network meta- analysis. Ann Plast Surg . 2019; 83(2):154-162. EBM level 3a....................................................127-135

Summary : This meta-analysis covers 14 studies with 994 patients comparing outcomes of keloid treatment. All subjects included excision but varied on adjuvant treatment method, if any. Patients with radiation as an adjuvant therapy fared best, though this did not reach statistical significance. C. Flaps and grafts Abdelwahab M, Kandathil CK, Most SP, Spataro EA. Utility of indocyanine green angiography to identify clinical factors associated with perfusion of paramedian forehead flaps during nasal reconstruction surgery. JAMA Facial Plast Surg . 2019; 21(3):206-212. EBM level N/A...........136-142

Summary : Indocyanine green angiography is an effective method to quantify relative neovascularization perfusion in forehead flaps.

Salibian AH, Menick FJ, Talley J. Microvascular reconstruction of the nose with the radial forearm flap: a 17-year experience in 47 patients. Plast Reconstr Surg . 2019; 144(1):199-210. EBM level 4...............................................................................................................................................143-154

Summary : The radial forearm free flap is a useful tool in total nasal reconstruction.