Double Flap Technique Research Articles

Double Flap Technique for Reconstruction of Anterior Skull Base Defects after Craniofacial Tumor Resection

Background: Successful reconstruction of large anterior skull base (ASB) defects after craniofacial resection of malignant skull base tumors is paramount for preventing cerebrospinal fluid (CSF) fistulas. The vascularized pedicled pericranial flap has been the gold standard for repair. However, flap necrosis and delayed CSF leaks can occur after adjuvant radiation therapy. We describe a double flap repair, where the pericranial flap is augmented inferiorly by a secondary vascularized nasoseptal flap (NSF) that is harvested and rotated using an endonasal endoscopic approach. This technique is illustrated in two patients who underwent resection of large sinonasal/anterior skull base malignancies with significant intracranial extension.

Double Mucosal and Myocutaneous Island Flap

Basal cell carcinomas (BCCs) on the lower eyelid are not uncommon, and depending on their histological type, they can be highly aggressive and difficult to eradicate. Numerous techniques have been proposed for the reconstruction of the lower lid margin after surgical excision of the lesion. To describe a double-flap technique consisting of a mucosal and myocutaneous V-Y advancement flap to repair full-thickness lower lid margin defects in a one-stage procedure under local anesthesia. Over a 12-year period (1995-2007), 33 patients with BCC underwent lower eyelid reconstruction. After tumor excision, a triangular mucosal flap with a central pedicle was used to repair the inner layer. A similar triangular-shaped myocutaneous flap was obtained from the inferior orbicularis oculus muscle and sutured in a V-Y fashion to build the outer layer. All 33 patients achieved satisfactory functional and cosmetic results. Slight scleral show and discrete rounded lower eyelid were the main adverse effects. No additional surgery was needed. This double V-Y advancement flap is a simple, useful alternative procedure to close full-thickness defects in the lower lid margin. Aesthetic and functional outcome is good.

Split earlobe repair using a double-flap technique.

The authors describe a new method for the reconstruction of the split earlobe in which the earring hole is retained in its original position using double skin flaps to strengthen the repair.

Therapy of Chronic Nasal Disease in the Dog

home Acta Veterinaria Brno Journal of the University of Veterinary Sciences Brno, Czech Republic Search:

HISTOLOGY OF THE URETHRAL PLATE: IMPLICATIONS FOR HYPOSPADIAS REPAIR

No AccessJournal of UrologyHypospadias1 Sep 2000HISTOLOGY OF THE URETHRAL PLATE: IMPLICATIONS FOR HYPOSPADIAS REPAIR WARREN SNODGRASS, KATHLEEN PATTERSON, J. CHADWICK PLAIRE, RICHARD GRADY, and MICHAEL E. MITCHELL WARREN SNODGRASSWARREN SNODGRASS More articles by this author , KATHLEEN PATTERSONKATHLEEN PATTERSON More articles by this author , J. CHADWICK PLAIREJ. CHADWICK PLAIRE More articles by this author , RICHARD GRADYRICHARD GRADY More articles by this author , and MICHAEL E. MITCHELLMICHAEL E. MITCHELL More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67233-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We define the histology of the urethral plate in boys with hypospadias. Materials and Methods: Subepithelial biopsies of the urethral plate were obtained in 17 boys, including 13 with distal and 4 with penoscrotal hypospadias. Ventral penile curvature was noted in 5 cases. Specimens were evaluated by 7 light microscopy after hematoxylin and eosin staining. Results: All biopsies demonstrated well vascularized connective tissue comprised of smooth muscle and collagen. There was no evidence of fibrous bands or dysplastic tissue. Conclusions: The urethral plate consists of epithelium overlying connective tissue. We found no histological evidence of fibrous cords historically considered responsible for chordee. References 1 : The correction of hypospadias: a review. Urol Surv1958; 8: 2. Google Scholar 2 : Basic instructions for hypospadias repair. In: . Philadelphia: W. B. Saunders Co.1994: 551. Google Scholar 3 : History of external genital surgery. In: . Boston: Little, Brown and Co.1973: 3. Google Scholar 4 : Controversies in hypospadias surgery: the urethral plate. Dial Pedi Urol1996; vol. 19. No. 8. Google Scholar 5 : A critique on the repair of hypospadias. Surgery1952; 31: 885. Google Scholar 6 : Changing concepts of hypospadias curvature lead to more onlay island flap procedures. J Urol1994; 151: 191. Link, Google Scholar 7 : Microscopic studies of curvature-causing structures in hypospadias. Scand J Plast Reconstr Surg1980; 14: 249. Google Scholar 8 : The congenital anomalies of the lower urinary tract. Br J Urol1956; 28: 118. Google Scholar 9 : Etiologic considerations in penoscrotal hypospadias repair. J Urol1978; 120: 229. Link, Google Scholar 10 : Anatomical studies of hypospadias. J Urol1998; 160: 1108. Link, Google Scholar 11 : The origin and fate of the urethral plate in man. J Anat1954; 88: 413. Google Scholar 12 : Embryogenesis of chordee. J Urol1975; 114: 769. Link, Google Scholar From the Division of Pediatric Urology, Children’s Medical Center, Dallas, Texas, and Department of Pediatric Pathology and Division of Pediatric Urology, Seattle Children’s Hospital and Regional Medical Center, Seattle, Washington© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited BySpinoit A, Van Praet C, Groen L, Van Laecke E, Praet M and Hoebeke P (2018) Congenital Penile Pathology is Associated with Abnormal Development of the Dartos Muscle: A Prospective Study of Primary Penile Surgery at a Tertiary Referral CenterJournal of Urology, VOL. 193, NO. 5, (1620-1624), Online publication date: 1-May-2015.Snodgrass W and Prieto J (2009) Straightening Ventral Curvature While Preserving the Urethral Plate in Proximal Hypospadias RepairJournal of Urology, VOL. 182, NO. 4S, (1720-1725), Online publication date: 1-Oct-2009.Snodgrass W (2018) A Farewell to ChordeeJournal of Urology, VOL. 178, NO. 3, (753-754), Online publication date: 1-Sep-2007.XU J, LI S, LI Y, LI Q, LIU L and WANG Y (2018) LENGTHENING URETHRAL PLATE WITH INNER PREPUTIAL SKIN GRAFTS: A MODIFICATION OF THE ONLAY TECHNIQUEJournal of Urology, VOL. 173, NO. 1, (202-203), Online publication date: 1-Jan-2005.JAYANTHI V (2018) The Modified Snodgrass Hypospadias Repair: Reducing the Risk of Fistula and Meatal StenosisJournal of Urology, VOL. 170, NO. 4 Part 2, (1603-1605), Online publication date: 1-Oct-2003.Palmer L, Palmer J, Franco I, Friedman S, Kolligian M, Gill B and Levitt S (2018) The “Long Snodgrass”: Applying the Tubularized Incised Plate Urethroplasty to Penoscrotal Hypospadias in 1-stage Or 2-stage RepairsJournal of Urology, VOL. 168, NO. 4 Part 2, (1748-1750), Online publication date: 1-Oct-2002.VELA D, MÉNDEZ R, SOMOZA M, LIRAS J and PAIS E (2018) LENGTHENING THE URETHRAL PLATE WITH A DOUBLE FLAP TECHNIQUE: A NEW PROCEDURE FOR CORRECTION OF PRIMARY HYPOSPADIAS WITH CHORDEEJournal of Urology, VOL. 167, NO. 1, (306-308), Online publication date: 1-Jan-2002. Volume 164Issue 3 Part 2September 2000Page: 988-990 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.KeywordsurethrahypospadiashistologypenisMetricsAuthor Information WARREN SNODGRASS More articles by this author KATHLEEN PATTERSON More articles by this author J. CHADWICK PLAIRE More articles by this author RICHARD GRADY More articles by this author MICHAEL E. MITCHELL More articles by this author Expand All Advertisement PDF DownloadLoading ...

Double Purpose Penile Skin Flap One-Stage Urethroplasty for Repair of Distal Penile Hypospadias Cripples

A new one-stage urethroplasty operation is presented. The author called it "double purpose penile skin flap technique". It is recommended for the substitution of distal urethral defect when its length is equal to or less than half the circumference of the penile shaft in cases following multiple failed hypospadias repairs.

Transverse Island Flap and Double Flap Procedure in the Treatment of Congenital Epispadias in 32 Patients

According to major reports in the literature satisfactory cosmetic and genital results after correction of male epispadias have been achieved in only 50 per cent of the patients. Since 1976 we have been using the Duckett transverse island flap principle adapted to epispadiae anatomical conditions. The original technique was used in our initial 18 patients and the Asopa double flap technique was performed in the subsequent 14. Excellent results were obtained in both series. However, there was a high percentage of fistulas that required secondary repair. The techniques and results are described.

Repair of Facial Defects with Periosteal Flaps in Two Horses

Facial defects that extended into the sinuses of two horses were repaired by using adjacent periosteum to cover the defects, using either a single flap or double flap technique. Acceptable cosmetic appearance was restored in both horses. Resistance to penetration of a needle and ultrasonic scanning demonstrated bony bridging in one horse.

A double flap technique for the closure of oro-nasal and oro-antral fistulae

A double flap technique for the closure of oro-nasal fistulae is described. It provides immediate epithelial lining on both oral and nasal aspects of the repair, and has advantages over other double flap techniques described in the literature, in that both flaps are robust, and that only one small area of palatal bone is left denuded at the conclusion of the operation. The technique may be modified for use in the treatment of oro-antral fistulae.